LYR 铁蛋白 S-LDH对初诊儿童急性早幼粒细胞白血病病情转归影响及早期预警意义

doi:10.3969/j.issn.1006-6233.2024.12.018

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摘要 目的: 探讨循环淋巴细胞比例(LYR)、铁蛋白、游离乳酸脱氢酶(S-LDH)对初诊儿童急性早幼粒细胞白血病(APL)病情转归的影响及早期预警意义。方法: 选取我院2018年1月至2023年12月收治的89例初诊儿童APL患者,根据治疗后病情转归分为完全缓解(CR)组、非CR组。比较两组临床资料、LYR、铁蛋白、S-LDH水平,分析LYR、铁蛋白、S-LDH与病情转归的净相关性,ROC曲线分析LYR、铁蛋白、S-LDH预测病情转归的价值,并分析不同LYR、铁蛋白、S-LDH表达水平对病情转归的影响。结果: 非CR组LYR低于CR组,铁蛋白、S-LDH高于CR组(P<0.05);LYR、铁蛋白、S-LDH与病情转归显著相关(P<0.05),三者的净相关性系数分别为-0.825、0.860、0.812;LYR、铁蛋白、S-LDH预测病情转归的最佳截断值分别为34.12、261.22、511.39,AUC分别为0.779、0.802、0.797;OR危险度分析,LYR、铁蛋白、S-LDH高表达患者非CR的风险分别是低表达患者的0.120、12.783、9.579倍;LYR、铁蛋白、S-LDH联合预测非CR的AUC为0.916(95%CI:0.838-0.964),敏感度为88.89%,特异度为83.10%。结论: LYR、铁蛋白、S-LDH水平与APL患者病情转归密切相关,为临床早期评估预测APL患者病情转归提供参考,以针对性制定相应干预方案,改善预后。

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关键词 ：早幼粒细胞白血病, 病情, 循环淋巴细胞比例, 铁蛋白, 游离乳酸脱氢酶

Abstract：Objective: To investigate the effects of circulating lymphocyte ratio (LYR), ferritin and serum-lactate dehydrogenase (S-LDH) on the prognosis of children with newly diagnosed acute promyelocytic leukemia (APL)and its early warning significance. Methods: A total of 89 children with newly diagnosed APL admitted to our hospital from January 2018 to December 2023 were divided into complete response (CR) group and non-CR group according to the prognosis after treatment. Clinical data, levels of LYR, ferritin and S-LDH were compared between the two groups, and the net correlation between LYR, ferritin and S-LDH with disease outcome was analyzed. Receiver operating characteristic (ROC) curves were conducted to analyze the value of LYR, ferritin and S-LDH in predicting the disease outcome, and evaluate the effects of different expression levels of LYR, ferritin and S-LDH on the disease outcome. Results: The LYR in non-CR group was significantly lower than that in CR group, and the ferritin and S-LDH were significantly higher than those in CR group (P<0.05). LYR, ferritin and S-LDH were significantly correlated with the disease outcome (P<0.05), and the net correlation coefficients of LYR, ferritin and S-LDH were -0.825, 0.860 and 0.812, respectively. The optimal cut-off values of LYR, ferritin and S-LDH were 34.12, 261.22 and 511.39, respectively, and the area under the ROC curve (AUC) was 0.779, 0.802 and 0.797, respectively. Odds ratio (OR) for risk analysis showed that the risk of non-CR in patients with high LYR, ferritin and S-LDH expression was 0.120, 12.783 and 9.579 times higher than that in patients with low expression, respectively. The AUC of combined prediction of LYR, ferritin, and S-LDH for non-CR was 0.916 (95%CI: 0.838-0.964), with the sensitivity of 88.89%, and the specificity of 83.10%. Conclusion: The levels of LYR, ferritin and S-LDH are closely related to the disease outcome of APL patients, which provide a reference for clinical evaluation and prediction in early APL patients, formulating corresponding intervention programs to improve the prognosis.

Key words： Promyelocytic leukemia Disease Circulating circulating lymphocyte ratio Ferritin Serum-lactate dehydrogenase

基金资助:云南省卫生健康委临床医学中心2020-2022年建设项目,(编号:202002AF231201)

引用本文:

雷庆龄, 林云碧, 黄体龙, 宋春艳, 肖祖刚. LYR 铁蛋白 S-LDH对初诊儿童急性早幼粒细胞白血病病情转归影响及早期预警意义[J]. 河北医学, 2024, 30(12): 2038-2043.
LEI Qingling, LIN Yunbi, HUANG Tilong, et al. Effects of LYR Ferritin and S-LDH on the Prognosis of Children with Newly Diagnosed Acute Promyelocytic Leukemia and its Early Warning Significance. HeBei Med, 2024, 30(12): 2038-2043.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2024.12.018 或 http://www.hbyxzzs.cn/CN/Y2024/V30/I12/2038

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