急性髓细胞白血病患者血清sICAM-1和sVCAM-1水平变化及临床应用

Change and significance of serum sICAM-1 and sVCAM-1 levels in acute myeloid leukemia

目的:探讨急性髓细胞白血病(AML)患者血清细胞间黏附分子-1(ICAM-1,CD54)和血管细胞黏附分子-1(VCAM-1,CD106)的水平变化及其临床应用。方法:用酶联免疫吸附试验(ELISA)测定56例初诊断的急性髓细胞白血病患者治疗前、后的血清和20例正常对照组血清可溶性ICAM-1(sICAM-1)和可溶性VCAM-1(sVCAM-1)的水平。结果:AML患者化疗前血清sICAM-1和sVCAM-1水平升高,与正常对照组比较有高度显著性差异(P<0.01),缓解后降低,与对照组比较无显著性差异(P>0.05)。复发患者血清sICAM-1和sVCAM-1水平升高,与缓解组及正常对照组比较有高度显著性差异(P<0.01)。M4和M5患者血清sVCAM-1水平高于其他亚型患者(P<0.05)。初发AML患者中,血清sI-CAM-1和sVCAM-1水平高者治疗效果比血清sICAM-1和sVCAM-1水平正常者较差。结论:在AML患者中,血清sICAM-1和sVCAM-1水平的变化有助于判断患者的病情进展、疗效及预后,对指导临床选择化疗方案有一定的帮助。

Objective： To study the change and significance of sICAM-1 and sVCAM -1 in patients with acute myelocytic leukemia（AML）. Methods： Fifty-six AML patients were as trial group and 20 subjects were as control group; serum samples were obtained from patients in trial group before and after treatment and subjects in control group; concentrations of sICAM-1 and sVCAM-1 were determined with enzyme linked immunosorbent assay （ELISA） respectively. Results：Serum levels of sICAM-1 and sVCAM -1 in trial group were high before treatment, compared with control group, there was significant difference （ P 〈 0.01 ） ; and were in normal levels in remissive patients after treatment, compared with control group, there was no significant difference （ P 〉 0.05 ）. Serum levels of sICAM-1 and sVCAM -1 in relapsed AML patients were elevated, compared with control group and remissive patents, there was significant difference （ P 〈 0.01 ）. Serum levels of sVCAM -1 in M4 and M5 were higher than those in other subtypes of AML （P 〈 0.05 ）. Patients with elevated serum levels of sICAM-1 and sVCAM-1 in initial had poorer response to treatment than those with normal serum levels of sICAM-1 and sVCAM-1. Conclusion： The change of sICAM-1 and sVCAM -1 of AML patients can used for the analysis of therapeutic effect, progress of disease and prognosis; and it can also provide useful information for the chemotherapy.