神经母细胞瘤患儿血清肿瘤标志物水平变化的临床意义

Clinical values of serum tumor marker in children neuroblastoma

目的:探讨血清神经元特异性烯醇化酶(neuron-specific enolase,NSE)、血清乳酸脱氢酶(lactate dehydrogen,LDH)、血清铁蛋白(ferritin,SF)肿瘤标志物水平的变化及其在神经母细胞瘤(NB)分期、评价疗效及复发中的作用。方法:采用ELISA方法检测血清NSE和SF,应用全自动生化分析仪,采用速率法测定血清LDH。分析46例NB患儿3种肿瘤标志物不同分期、治疗前后(有效及复发)肿瘤标志物水平变化。结果:患儿治疗有效后,NSE、LDH和SF较治疗前明显降低,差异有统计学意义(P<0.05);Ⅲ-Ⅳ期NB患儿的血清NSE、LDH和SF水平明显高于Ⅰ-Ⅱ期NB患儿,差异有统计学意义(P<0.05);复发患儿血清NSE、LDH和SF与疾病初期比较无差异(P>0.05);NSE水平与SF水平呈正相关(r=0.475,P<0.05)。结论:采用NSE、LDH、SF 3种肿瘤标志物联合检测对NB分期、评价疗效及复发有一定价值。

Objective：To investigate the significance of neuron-specific enolase（NSE）,lactate dehydrogenase（LDH） and ferritin（SF） in serum in the staging,therapeutic evaluation and relapse in neuroblastoma（NB）.Methods：Forty-six patients with NB were analyzed for serum NSE and SF by ELISA.LDH was measured by fully automated clinical chemistry analyzer.The different stages and the levels of the 3 tumor markers before and after therapy（remission and relapse） were analyzed.Results：The serum levels of NSE,LDH and SF in effective treated patients were significantly lower than those in initially treated children（P0.05）.The serum levels of NSE,LDH and SF in stage Ⅲ-Ⅳ were obviously higher than those in stage Ⅰ-Ⅱ（P0.05）.There were no differences of serum NSE,LDH and SF levels before and after treatment in relapse cases（P0.05）.Both NSE and SF were positively correlated with the course of the disease（r=0.475,P0.05）.Conclusion：The serial detection of tumor markers is valuable for the staging,therapeutic response evaluation and relapse in NB.