测定脑脊液纤维蛋白连结素和β_2微球蛋白对中枢神经系统白血病诊断的意义

THE SIGNIFICANCE OF DETECTING CEREBROSPINAL FLUID FIBRONECTIN AND β2-MICROGLOBULIN IN THE DIAGNOSIS OF CENTRAL NERVOUS SYSTEM LEUKEMIA

分别用免疫扩散法和放射免疫法测定１６例急性白血病或淋巴瘤患者脑脊液（ＣＳＦ）中纤维蛋白连接素（ＦＮ）和β２微球蛋白（β２－Ｍ），发现首次ＣＳＦ中ＦＮ水平６例中枢神经系统白血病患者比无ＣＮＳＬ患者显著增高，确诊ＣＮＳＬ时β２－Ｍ水平显著高于未确诊时和无ＣＮＳＬ的患者。鞘内化疗后病情好转与β２－Ｍ水平下降相一致，与ＦＮ水平无关，无ＣＮＳＬ患者ＦＮ水平反而有所上升。因此测定ＣＳＦ中ＦＮ对预计急性白血病发生ＣＮＳＬ有一定意义，β２－Ｍ对ＣＮＳＬ的诊断和疗效评估更具有价值。

n this article,for 16 patients with acute leukemia or lymphoma fibronectin and β2-microglogulin(β2-M)level in crerbroapinal fluid(CSF)were determinated by immunodiffusion assayand radioimunoassy respetively. Fibronectin level in the first CSF was significantly higher in 6patients with Central nervous system leukemia(CNSL ) than in patients without CNSL(1.91±0.69mg/L versus 0.74±0.34mg/, p<0.01 ).β2-M level in those of CNSL(3.90±0.89mg/L)was much higher than that of prior to diagnosis of CNSL(1.90±0.80mg/L)and those without CNSL. 23± 46mg/L) (p<0.01). After intrathecal chemotherapy, the clinical condition improved inaccordance with decreasing of β2-M level( 2.12±1. 20mg/L), and no relationship to change offibronectin level( 1. 90±0. 55mg/L). on the contrary, fibronectin level( 1.21±0. 49mg/L)increased in patients without CNSL.These results suggest that fibronectin level in the first CSF may bepredictive for the development of CNSL in acut leukemia and β2-M level is very valuable indiaghosing CNSL and estimating therapeutic responce.