神经元特异性烯醇化酶对儿童神经母细胞瘤诊治的临床价值

Clinical values of serum neuron-specific enolase in children with neuroblastoma

目的探讨血清神经元特异性烯醇化酶(NSE)在神经母细胞瘤患儿诊治方面的意义。方法比较28例患儿治疗前和治疗后,及不同临床分期的血清NSE,乳酸脱氢酶(LDH),天冬氨酸氨基转移酶(AST),碱性磷酸酶(ALP)和铁蛋白(SF)水平的变化,研究NSE与LDH,SF水平的相关性。结果治疗后患儿NSE水平(中位数为12.8ng/ml)比治疗前(中位数为41.4ng/ml)明显降低(P<0.05)。治疗后LDH(中位数277.0U/L),AST(中位数37.5U/L)和SF(中位数38.2ng/ml)水平均明显低于治疗前(中位数分别为544.5U/L,46.1U/L,107.1ng/ml)(P<0.05)。不同临床分期肿瘤的血清NSE和LDH的水平有显著性差异(P<0.05)。NSE与LDH水平呈正相关(r=0.661,P<0.01),与SF水平呈正相关(r=0.800,P<0.01)。结论血清NSE可作为诊断神经母细胞瘤的首选肿瘤标志物。

Objective To study the clinical values of neuron-specific enolase （NSE） in children with neuroblastoma. Methods The levels of NSE, lactic dehydrogenase （LDH）, aspartate transaminase （AST）, ferrtin （SF） and alkaline phosphatase （ALP） pre- and after-treatment were analyzed. The levels in different clinical stages were compared and the correlation between NSE and LDH, NSE and ferrtin were also investigated. Results The levels of serum NSE, LDH, AST, ALP and SF were significantly lower in after-treatment patients （median value was 12.8 ng/ml, 277.0 U/L, 37.5 U/L, 38.2 ng/ml, respectively） compared with pre-treatment （median value is 41.4 ng/ml, 544.5 U/L, 46.1 U/L, 107.1 ng/ml, respectively）. The levels of NSE and LDH were higher in stage Ⅲ- Ⅳ when compared with those of stage Ⅰ - Ⅱ （P 〈 0.05）. Correlation analysis showed that the levels of NSE was positively correlated with LDH （r = 0.661 ,P 〈 0.01） and SF （r = 0.8 ,P 〈 0.01）. Conclusion NSE is a valuable tumor marker in the diagnosis of neuroblastoma, it can be detected combined with other tumor markers to improve the diagnostic rate of neuroblastoma in children.