急性白血病患者血清及脑脊液中SDF-1α的检测及其临床意义

目的探讨急性白血病(acute leukemia,AL)患者血清及脑脊液(cerebrospinal fluid,CSF)中基质细胞衍生因子-1α(stromal cell-derived factor-lα,SDF-1α)的水平及临床意义。方法采用酶联免疫吸附法(enzyme linked immunosorbent assay,ELISA)分别检测26例初诊未治及经标准方案化疗2疗程后AL患者和10例非恶性血液病患者(对照组)的血清及CSF中SDF-1α的水平。结果①初诊未治及经标准方案化疗2疗程后急性淋巴细胞白血病(ALL)组、急性髓细胞白血病(AML)组血清及CSF中SDF-1α浓度明显高于对照组(P<0.01);ALL组明显高于AML组(P<0.01)。②初诊未治及经标准方案化疗2疗程后中枢神经系统白血病(CNSL)组、非中枢神经系统白血病(N-CNSL)组血清及CSF中SDF-1α浓度明显高于对照组(P<0.01);CNSL组明显高于N-CNSL组(P<0.01)。结论①AL患者初诊时及化疗后血清及CSF中SDF-1α水平呈高水平表达,提示它可以作为AL特别是CNSL的一种病情变化检测指标,可能与AL耐药及复发相关。②CNSL患者血清及CSF中SDF-1α浓度有一定的相关性,提示在CNSL患者仅检测血清SDF-1α水平就可能有助于判断病情变化,避免反复腰穿给患者带来痛苦。

Objective To study the level and clinical significance in the serum and cerebrospinal fluid（CSF） of SDF-1α in acute leukemia. Methods The serum and CSF of SDF-1α was measured by enzyme linked immunosorbent assay（ELISA）in 26 acute leukemia who were newly diagnosed and after 2 treatment scheme of standard chemotherapy,10 person of non-malignant hematological disease（control group）. Results The serum and CSF of SDF-1α in acute lymphocytic leukemia （ALL）, acute myelocytic leukemia（AML）who were newly diagnosed and after 2 treatment scheme of standard chemotherapy were significantly higher than that in control groups（P0.01）;The level of SDF-1α in ALL groups was significantlyhigher than that in AML groups（P0.01）. ②The serum and CSF of SDF-1α in CNSL,N-CNSL who were newly diagnosed and after 2 treatment scheme of standard chemotherapy were significantly higher than that in control groups（P0.01）;The level of SDF-1α in CNSL groups was significantly higher than that in N-CNSL groups（P0.01）. Conclusion ①High level of SDF-1α in acute 1eukemia who were newly diagnosed and after chemotherapy, so SDF-1α could be considered as a detective index in AL especially in CNSL,and it may relate with primary drug resistance and recrudescence.②The serum of SDF-1α may have a relationship with that in CSF in CNSL,it seemed that the serum of SDF-1αmay exchange that in CSF to judge patient＇s condition changes in CNSL,and avoided to produce more pain for patients by repeatedly lumbar puncture.