急性白血病患者血清可溶性c-kit受体检测的临床意义

The study on the clinical significance of determination of serum soluble c-kit receptor in the patients with acute leukemia

目的检测急性白血病(AL)患者血清可溶性c-kit受体(s-kit)含量并研究其临床意义。方法采用酶联免疫吸附试验(ELISA法)检测初诊的45例急性非淋巴细胞白血病(ANLL)和40例急性淋巴细胞白血病(ALL)患者血清s-kit含量,并观察s-kit含量与ANLL患者临床特征及其与ANLL化疗疗效之间的关系。结果ANLL患者s-kit含量高于ALL组和对照组(分别为P<0·001);ALL组与对照组差异无显著性(P>0·05)。在ANLL组中,各FAB亚型的s-kit含量依次为:M1、M2>M3>M6>M4、M5。血清LDH水平增高的ANLL患者s-kit含量明显高于LDH水平正常者(P<0·01)。完全缓解(CR)的ANLL患者s-kit含量高于未缓解(NR)者,但二者s-kit含量无显著差异(P>0·05)。结论血清s-kit水平升高对于ANLL的诊断以及ANLL和ALL的鉴别诊断有一定参考价值。ANLL各FAB亚型的s-kit水平不尽一致,以M1-M2型水平最高;s-kit水平与ANLL患者的肝脾肿大、外周血白细胞计数等无明确关系,而与ANLL患者血清LDH含量成正比关系。s-kit水平较低的ANLL患者化疗疗效可能较差。

Objective： To determine serum soluble c-kit receptor （s-kit） in the patients with acute leukemia（AL） and study its clinical significance. Methods： ELISA assay was used to measure levels of serum s-kit in 45 cases of acute nonlymphoid leukemia （ANLL） and 40 cases of acute lymphoid leukemia（ALL）. Twenty healthy adults were selected as the controls. Meanwhile, the relationship between s-kit levds in ANLL and the clinical feature of ANLL and effects of chemotherapy for ANLL were also studied. Results： The levels of s-kit in the patients with ANLL were 8.03 ± 3.81 ng/ml, which was significantly higher than those of the patients with ALL and the controls as well （ P 〈 0. 001 respectively）. The s-kit levels in various subsets of ANLL were respectivdy M1, M2 〉 M3 〉 M6 〉 M4, Ms. The s-kit levels of ANLL with higher LDH levds were higher than those with normal LDH levels （ P 〈 0.01 ）. The s-kit levels in the patients with ANLL in complete remission （CR） group were higher than those in non-remission （NR） group. Conclusion： （1）. The higher levels of s-kit may help to diagnose ANLL. （2）. There are higher s-kit levds in M1, M2 subsets of ANLL. S-kit level is related to LDH levd in ANLL. （3）. The patients with ANLL with lower s-kit levels may have Imor effects of chemotherapy.