碱性磷酸酶在青少年骨肉瘤患者疗效评价中的临床应用

Clinical application of alkaline phosphatase in the evaluation of the curative effect of juvenile osteosarcoma

目的通过青少年骨肉瘤规范化治疗前后体内总碱性磷酸酶(TALP)和骨型碱性磷酸酶(BALP)变化,评估患者治疗效果、复发或转移风险。方法选取2007年1月-2015年6月患者120例,分为骨肉瘤组、骨折组,另选取60例本院健康体检者为对照组,每组60例。检测各组TALP和BALP含量。结果病程2周骨肉瘤组、骨折组血清TALP、BALP水平明显高于对照组,差异有统计学意义(P<0.05)。骨折组发病6周、8周后TALP、BALP水平呈下降趋势。骨肉瘤组肿瘤切除、化疗药物敏感、无远处转移患者TALP、BALP水平持续下降,术后3个月与对照组比较差异有统计学意义(P<0.05)。化疗效果差、术后局部复发、早期出现转移的骨肉瘤患者TALP、BALP水平高于对照组,差异有统计学意义(P<0.05)。结论检测青少年骨肉瘤患者体内TALP、BALP变化,对手术前后化疗效果评估、肿瘤复发、转移风险预测有重要意义。

Objective To evaluate the treatment effect, recurrence and metastasis risk of juvenile osteosarcoma alter standard- ized treatment by observing the changes of total alkaline phosphatase （TALP） and bone alkaline phosphatase （BALP）. Methods From January 2007 to June 2015, 120 patients were divided into the osteosarcoma group and the fracture group, and 60 cases accepting health examination were collected as the control group, with 60 cases in each group. The contents of TALP and BALP in each group were detected. Results The TALP and BALP levels of the osteosarcoma group and the fracture group were higher than the control group, and the differences were statistically significant（P 〈0.05） ; the TALP and BALP levels of the fracture group decreased after 6 weeks and 8 weeks. In the osteosareoma group, TALP and BALP levels in patients with tumor resection, chemotherapy sensitive and non distant metastasis decreased, but the difference of that after 3 months was sta- tistically significant compared with the control group（ P 〈 0.05 ） ; TALP and BALP levels in the patients with poor chemotherapy effect, partial recurrence after operation and early metastasis were higher than the control group, with the differences statistically significant（P 〈 0.05 ）. Conclusion It＇s significant to evaluate the effect of chemotherapy, the risk of tumor recurrence and metastasis to detect the changes of TALP and BALP in patients with juvenile osteosarcoma.