急性白血病患者血清sFas,TNFα水平及其与疗效的关系

SERUM CONCENTRATION OF SOLUBLE Fas AND TUMOR NECROSIS FACTOR-α AND THEIR CLINICAL CORRELATION WITH CHEMOTHERAPY OUTCOME IN PATIENTS WITH ACUTE LEUKEMIA

目的 :探讨急性白血病患者血清可溶性跨膜蛋白 (s Fas)和肿瘤坏死因子 α(TNFα)的变化及意义。方法 :采用 EL ISA法测定 30例急性白血病患者血清 s Fas,放免法测定 32例急性白血病患者血清 TNFα含量 ,并与正常对照组比较。结果 :急淋白血病患者未完全缓解组 s Fas为 (7.14± 2 .18) μg/L,急非淋白血病未完全缓解组为 (9.6 9± 3.5 1) μg/L,均明显高于正常对照组的 (3.49± 2 .36 ) μg/L,亦明显高于其相应的完全缓解组。s Fas比正常对照组高出 2倍的患者化疗获得完全缓解的机会明显下降。急性白血病患者初发未治时血清 TNFα为 (6 .0 7± 1.32 ) nmol/L,化疗后未完全缓解者为 (5 .79± 1.2 7) nm ol/L,复发者为 (7.5 0± 1.6 7) nm ol/L,均明显高于正常对照组的 (2 .32± 0 .90 ) nm ol/L 和化疗后完全缓解者的 (4 .14±1.5 ) nm ol/L。结论 :血清 s Fas,TNFα在急性白血病患者均明显升高 ,是预后不良的因素。

Objective: To determine the serum concentration of soluble Fas(sFas) and tumor necrosis factor α(TNFα)and to evaluate their clinical correlation with chemotherapy outcome in patients with acute leukemia Methods: Enzyme linked immunosorbent assay was used to measure sFas, radioimmunoassay was used to measure TNFα Results: Serum sFas concentration was (7 14±2 18)μg/l, (9 69±3 51)μg/l in acute lymphocytic and non lymphocytic leukemia patients respectively, and both were significantly higher than that in the control group(3 49±2 36) μg/l, and also significantly higher than that in its corresponding complete remission patients Patients with higher sFas concentration showed low complete chemotherapy remission rate Patients with acute leukemia had a significantly increased level of TNFα(6 07±1 32)nmol/L before treatment, as compared with that in complete remission patients ( 4 14±1 5)nmol/L ,in non complete remission patients(5 79±1 27)nmol/L and in relapsed patients(7 50±1 67)nmol/L,while level of TNFαin the control group was (2 32±0 90)nmol/L Infection had influence on the TNFαlevel Conclusion: Acute leukemia patients had higher serum concentration of both sFas and TNFα,which was probably related to poor prognosis Determination of sFas and TNFαmay be helpful to evaluate chemotherapy result