尿液氨基酸代谢物与肿瘤特异性生长因子联检在评估急性白血病疗效中的应用价值
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摘要
目的:探讨尿液氨基酸代谢物-尿酪氨酸(urinary tyrosin,UT)与肿瘤特异性生长因子(TSGF)联合检测在急性白血病(AL)病情观察和疗效评估中的应用价值。方法:87例AL患者的UT采用化学显色法,血清TSGF采用全自动生化分析仪速率法动态监测,对各疗效组之间2指标的水平进行统计分析,并与50例健康对照组比较。结果:87例AL患者治疗后UT和TSGF水平较治疗前显著下降(P <0. 01)。未缓解组(NR)和部分缓解(PR)组UT值明显高于完全缓解(CR)组(P <0. 01,P <0. 05)和对照组(P <0. 01,P <0. 01),NR组UT值明显高于PR组(P <0. 05),CR组UT值明显高于对照组(P <0. 05)。NR和PR组TSGF值明显高于CR组(P <0. 01,P <0. 01)和对照组(P <0. 01,P <0. 01),NR组TSGF值明显高于PR组(P <0. 05),在CR组与对照组之间无差异(P> 0. 05)。结论:UT和TSGF水平与AL患者体内肿瘤细胞代谢相关,UT可对CR期患者进行复发预测,而UT和TSGF 2指标的联合动态监测,可作为AL患者病情变化、疗效评估、预后判断和复发预测的指标。
Objective: To investigate the clinical importance of combined detection of urinary amino acid metabolite——urinary tyrosine( UT) and tumor specific growth factor( TSGF) in the disease observation and curative effect evaluation of acute leukemia( AL). Methods: In 87 cases of AL,the UT and TSGF levels w ere detected by using chemical chromogenic method and continuous monitoring method respectively. The 2 indicators of each treatment group w ere statistically analyzed and compared w ith that of 50 healthy control group. Results: In 87 AL patients,the levels of UT and TSGF after treatment w ere significantly low er than those before treatment( P < 0. 01). The level of UT in nonremission( NR) group and partial remission( PR) group w as significantly higher than that in completely remission( CR)group( P < 0. 01,P < 0. 05) and control group( P < 0. 01,P < 0. 01),The UT level in NR group w as significantly higher than that in PR group( P < 0. 05),the UT level in CR group w as significantly higher than that in control group( P < 0. 05). The levels of TSGF in NR and PR groups were significantly higher than those in CR and control groups( P< 0. 01,P < 0. 01). The level of TSGF in NR group w as significantly higher than that in PR group( P < 0. 05),but no significant difference existed betw een CR group and control group( P > 0. 05). Conclusion: UT and TSGF levels are related w ith the metabolism of tumor cells in AL patients. UT level can be used to predict the recurrence of patients w ith CR. The combined dynamical monitoring of these 2 indicators can be used as the indexes for observation of AL status,evaluation of therapeutic efficacy,prediction of prognosis and relapse of AL.
Objective: To investigate the clinical importance of combined detection of urinary amino acid metabolite——urinary tyrosine( UT) and tumor specific growth factor( TSGF) in the disease observation and curative effect evaluation of acute leukemia( AL). Methods: In 87 cases of AL,the UT and TSGF levels w ere detected by using chemical chromogenic method and continuous monitoring method respectively. The 2 indicators of each treatment group w ere statistically analyzed and compared w ith that of 50 healthy control group. Results: In 87 AL patients,the levels of UT and TSGF after treatment w ere significantly low er than those before treatment( P < 0. 01). The level of UT in nonremission( NR) group and partial remission( PR) group w as significantly higher than that in completely remission( CR)group( P < 0. 01,P < 0. 05) and control group( P < 0. 01,P < 0. 01),The UT level in NR group w as significantly higher than that in PR group( P < 0. 05),the UT level in CR group w as significantly higher than that in control group( P < 0. 05). The levels of TSGF in NR and PR groups were significantly higher than those in CR and control groups( P< 0. 01,P < 0. 01). The level of TSGF in NR group w as significantly higher than that in PR group( P < 0. 05),but no significant difference existed betw een CR group and control group( P > 0. 05). Conclusion: UT and TSGF levels are related w ith the metabolism of tumor cells in AL patients. UT level can be used to predict the recurrence of patients w ith CR. The combined dynamical monitoring of these 2 indicators can be used as the indexes for observation of AL status,evaluation of therapeutic efficacy,prediction of prognosis and relapse of AL.
引文
1姜正开.血浆D-二聚体检验对急性白血病患者病情判断和临床疗效的价值分析.中国保健营养,2016;26(21):344.
2张之南,沈悌.血液病诊断及疗效标准,科学出版社,2007;106-134.
3 Nishiwaki S,Miyamura K,Ohashi K,et al.Impact of a donor source on adult Philadelphia chromosome-negative acute lymphoblastic leukemia:a retrospective analysis from the Adult Acute Lymphoblastic Leukemia Working Group of the Japan Society for Hematopoietic Cell Transplantation.Ann Oncol,2013;24(6):1594-1602.
4 Sreedharan S,Petros JA,Master VA,et al.Aquaporin-1 protein levels elevated in fresh urine of renal cell carcinoma patients:potential use for screening and classification of incidental renal lesions.Dis Markers,2014;2014:135649.
5 MathéEA,Patterson AD,Haznadar M,et al.Noninvasive urinary metabolomic profiling identifies diagnostic and prognostic markers in lung cancer.Cancer Res,2014;74(12):3259-3270.
6 Aboud OA,Weiss RH.New opportunities from the cancer Metabolome.Clin Chem,2013;59(1):138-146.
7 O'Connell TM.Recent advances in Metabolomics in oncology.Bioanalysis,2012;4(4):431-451.
8 Zhang AH,Sun H,Qiu S,et al.Metabolomics in noninvasive breast cancer.Clin Chim Acta,2013;424:3-7.
9 Zhang AH,Sun H,Yan GL,et al.Metabolomics in diagnosis and biomarker discovery of colorectal cancer.Cancer Lett,2014;345(1):17-20.
10 Chen JL,Fan J,Yan LS,et al.Urine metabolite profiling of human colorectal cancer by capillary electrophoresis mass spectrometry based on MRB.Gastroenterol Res Pract,2012;2012:125890.
11 Wang X,Zhang A,Sun H.Power of metabolomics in diagnosis and biomarker discovery of hepatocellular carcinoma.Hepatology,2013;57(5):2072-2077.
12 Fan J,Hong J,Hu JD,et al.Ion chromatography based urine amino Acid profiling applied for diagnosis of gastric cancer.Gastroenterol Res Pract,2012;2012:474907.
13 Zhang A,Yan G,Han Y,et al.Metabolomics approaches and applications in prostate cancer research.Appl Biochem Biotechnol,2014;174(1):6-12.
14 Bryan GT.The role of urinary tryptophan metabolites in the etiology of bladder cancer.Am J Clin Nutr,1971;24(7):841-847.
15吴双,赵桂梅,王秋菊,等.尿液检测在肿瘤筛查中的应用研究进展.临床军医杂志,2013;41(10):1088-1089.
16 Duettmann W,Koidl C,Troppan K,et al.Serum and urine galactomannan testing for screening in patients with hematological malignancies.Med Mycol,2014;52(6):647-652.
17 Chinello C,Cazzaniga M,De Sio G,et al.Urinary signatures of renal cell carcinoma investigated by peptidomic approaches.PLo SOne,2014;9(9):e106684.
18侯华新,梁永红,赵农,等.正常人尿中单羟酚类物质含量的测定研究.广西医科大学学报,2000;17(5):754-755.
19 Kumar S,Lata K,Mukhopadhyay S,et al.Role of estrogen receptors in pro-oxidative and anti-oxidative actions of estrogens:a perspective J.Biochim Biophys Acta,2010;1800(10):1127-1135.
20 Siener R,Hesse A.The effect of a vegetarian and different omnivorous diets on urinary risk factors for uric acid stone formation.Eur JNutr,2003;42(6):332-337.
21李振玲,吴燕,来亚杰,等.肿瘤相关物质群(TSGF)检测的临床意义探讨.中日友好医院学报,2013;17(3):149-152.
22 Krull KR,Hockenberry MJ,Miketova P,et al.Chemotherapy-related changes in central nervous system phospholipids and neurocognitive function in childhood acute lymphoblastic leukemia.Leu Lymphoma,2013;54(3):535-540.
23 Yang J,Wang D.Clinical value of tumor-associated growth factor detection in the diagnosis of colorectal carcinoma.Nan Fang Yi Ke Da Xue Xue Bao,2007;27(10):1577-1579.
24 de Bont ES,Rosati S,Jacobs S,et al.Increased bone marrow vascularization in patients with acute myeloid leukaemia:a possible role for vascular endothelial growth factor.Br J Haematol,2001;113(2):296-304.
25 Aguayo A,Kantarjian HM,Estey EH,et al.Plasma vascular endothelial growth factor levels have prognostic significance in patients with acute myeloid leukemia but not in patients with myelodysplastic syndromes.Cancer,2002;95(9):1923-1930.
26逯广龙.血清中肿瘤特异性生长因子(TSGF)在诊断小儿急性淋巴细胞白血病中的临床意义.中国医药指南,2013;(35):111-112.
27 Martinez-Laperche C,Gomez-Garcia AM,Lassaletta A,et al.Detection of occult cerebrospinal fluid involvement during maintenance therapy identifies a group of children with acute lymphoblastic leukemia at high risk for relapse.Am J ematol,2013;88(5):359-364.
2张之南,沈悌.血液病诊断及疗效标准,科学出版社,2007;106-134.
3 Nishiwaki S,Miyamura K,Ohashi K,et al.Impact of a donor source on adult Philadelphia chromosome-negative acute lymphoblastic leukemia:a retrospective analysis from the Adult Acute Lymphoblastic Leukemia Working Group of the Japan Society for Hematopoietic Cell Transplantation.Ann Oncol,2013;24(6):1594-1602.
4 Sreedharan S,Petros JA,Master VA,et al.Aquaporin-1 protein levels elevated in fresh urine of renal cell carcinoma patients:potential use for screening and classification of incidental renal lesions.Dis Markers,2014;2014:135649.
5 MathéEA,Patterson AD,Haznadar M,et al.Noninvasive urinary metabolomic profiling identifies diagnostic and prognostic markers in lung cancer.Cancer Res,2014;74(12):3259-3270.
6 Aboud OA,Weiss RH.New opportunities from the cancer Metabolome.Clin Chem,2013;59(1):138-146.
7 O'Connell TM.Recent advances in Metabolomics in oncology.Bioanalysis,2012;4(4):431-451.
8 Zhang AH,Sun H,Qiu S,et al.Metabolomics in noninvasive breast cancer.Clin Chim Acta,2013;424:3-7.
9 Zhang AH,Sun H,Yan GL,et al.Metabolomics in diagnosis and biomarker discovery of colorectal cancer.Cancer Lett,2014;345(1):17-20.
10 Chen JL,Fan J,Yan LS,et al.Urine metabolite profiling of human colorectal cancer by capillary electrophoresis mass spectrometry based on MRB.Gastroenterol Res Pract,2012;2012:125890.
11 Wang X,Zhang A,Sun H.Power of metabolomics in diagnosis and biomarker discovery of hepatocellular carcinoma.Hepatology,2013;57(5):2072-2077.
12 Fan J,Hong J,Hu JD,et al.Ion chromatography based urine amino Acid profiling applied for diagnosis of gastric cancer.Gastroenterol Res Pract,2012;2012:474907.
13 Zhang A,Yan G,Han Y,et al.Metabolomics approaches and applications in prostate cancer research.Appl Biochem Biotechnol,2014;174(1):6-12.
14 Bryan GT.The role of urinary tryptophan metabolites in the etiology of bladder cancer.Am J Clin Nutr,1971;24(7):841-847.
15吴双,赵桂梅,王秋菊,等.尿液检测在肿瘤筛查中的应用研究进展.临床军医杂志,2013;41(10):1088-1089.
16 Duettmann W,Koidl C,Troppan K,et al.Serum and urine galactomannan testing for screening in patients with hematological malignancies.Med Mycol,2014;52(6):647-652.
17 Chinello C,Cazzaniga M,De Sio G,et al.Urinary signatures of renal cell carcinoma investigated by peptidomic approaches.PLo SOne,2014;9(9):e106684.
18侯华新,梁永红,赵农,等.正常人尿中单羟酚类物质含量的测定研究.广西医科大学学报,2000;17(5):754-755.
19 Kumar S,Lata K,Mukhopadhyay S,et al.Role of estrogen receptors in pro-oxidative and anti-oxidative actions of estrogens:a perspective J.Biochim Biophys Acta,2010;1800(10):1127-1135.
20 Siener R,Hesse A.The effect of a vegetarian and different omnivorous diets on urinary risk factors for uric acid stone formation.Eur JNutr,2003;42(6):332-337.
21李振玲,吴燕,来亚杰,等.肿瘤相关物质群(TSGF)检测的临床意义探讨.中日友好医院学报,2013;17(3):149-152.
22 Krull KR,Hockenberry MJ,Miketova P,et al.Chemotherapy-related changes in central nervous system phospholipids and neurocognitive function in childhood acute lymphoblastic leukemia.Leu Lymphoma,2013;54(3):535-540.
23 Yang J,Wang D.Clinical value of tumor-associated growth factor detection in the diagnosis of colorectal carcinoma.Nan Fang Yi Ke Da Xue Xue Bao,2007;27(10):1577-1579.
24 de Bont ES,Rosati S,Jacobs S,et al.Increased bone marrow vascularization in patients with acute myeloid leukaemia:a possible role for vascular endothelial growth factor.Br J Haematol,2001;113(2):296-304.
25 Aguayo A,Kantarjian HM,Estey EH,et al.Plasma vascular endothelial growth factor levels have prognostic significance in patients with acute myeloid leukemia but not in patients with myelodysplastic syndromes.Cancer,2002;95(9):1923-1930.
26逯广龙.血清中肿瘤特异性生长因子(TSGF)在诊断小儿急性淋巴细胞白血病中的临床意义.中国医药指南,2013;(35):111-112.
27 Martinez-Laperche C,Gomez-Garcia AM,Lassaletta A,et al.Detection of occult cerebrospinal fluid involvement during maintenance therapy identifies a group of children with acute lymphoblastic leukemia at high risk for relapse.Am J ematol,2013;88(5):359-364.