急性髓系白血病患者视黄醇结合蛋白检测的临床意义

Significance of Retinol-Binding Protein Expression in Patients with Acute Myeloid Leukemia

目的:研究急性髓系白血病(acute myeloid leukemia,AML)患者视黄醇结合蛋白(retinol-binding protein,RBP)的表达水平及其相关因素。方法:收集2012年10月至2016年2月入院初治AM L患者123例及健康体检者100例的资料。分析RBP与AM L患者性别、FAB分型、基因突变、白细胞数及长期预后等的相关性。结果:AM L患者RBP表达水平(34.44±14.08 mg/L)明显低于健康对照组(61.02±34.97 mg/L)(P<0.01)。M3患者RBP表达水平(40.74±15.79 mg/L)明显高于M4(28.40±13.64 mg/L)(P<0.01)与M5(31.97±15.31 mg/L)(P<0.05)患者,但与M2相比无显著性差异(35.20±11.51 mg/L)(P>0.05)。AML患者RBP表达水平与患者外周血白细胞数呈负相关(r=-0.352,P<0.01)。亚组分析发现,RBP表达水平与白细胞数负相关主要见于M4(r=-0.563,P<0.01)及M5患者(r=-0.423,P<0.01)。获得CR患者的RBP水平为48.64±9.24 mg/L,非常明显高于初始治疗前(P<0.01),但仍显著低于健康对照组(P<0.05),其中M3患者缓解后RBP水平为54.91±5.25 mg/L,非M3为41.36±7.33 mg/L,两者比较具有非常显著的差异(P<0.01)。结论:研究AM L患者RBP表达水平可能为AML病理生理机制研究及治疗提供一定的参考信息。

Objective： To investigate the expression of retinol-binding protein （RBP） in patients with acute myeloid leukemia （AML） and its related factors. Methods： The clinical data of 123 patients with AML from October 2012 to February 2016 and 100 healthy controls were collected and the correlation of RBP expression level with sex, French - American-British （FAB） subtypes, molecular mutations, peripheral white blood cells and long-term outcomes was analyzed. Results： Compared with AML patients, the RBP expression level was significantly higher in healthy controls （61.02±34.97 vs 34.44±14.08 mg/L） （ u = 8. 658 ,P 〈 0. 01 ）. Patients with M3 showed higher RBP level （40.74±15.79 rag/L） compared with that of M4 （ 28.40±13.64 rag/L） （ P 〈 0.01 ） and M5 （ 31.97±15.31 rag/L） （ P 〈 0. 05）. Negative correlation was observed for RBP and white blood cells in patients with AML （ r = - 0. 352, P 〈 0.001）, which was more remarkable in patients with M4 （r= -0.563, P〈 0.01） and M5 （r= -0.423, P〈 0. 01 ）. AML patients achieved complete remission （CR） （48.64±9.24 rag/L） showed higher RBP level than that before treatment （u = 4. 876, P 〈 0.01）, but lower than healthy controls （u = 2.106,P 〈0.05）. After CR, patients with M3 showed higher RBP level than that of non-M3 patients （54.91±5.25 mg/L vs 41.36±7.33 rag/L）（t = 8. 777 ,P 〈 0.01 ）. Conclusion： Detecting RBP expression may provide some useful information for urderstanding the pathophysiology and improving the treatment of patients with AML.