脑脊液脂蛋白脂肪酶表达和mRNA水平对视网膜母细胞瘤患儿病情的评估价值

Evaluation of progression and curative effect of retinoblastoma patients by detecting LPL and mRNA in CSF

目的 探讨脑脊液脂蛋白脂肪酶（LPL）和mRNA水平对视网膜母细胞瘤患儿病情的评估价值.方法 诊断试验研究.收集2015年10月至2017年5月首都医科大学附属北京同仁医院收治及规范化疗的视网膜母细胞瘤患儿36例,其中19例诊断为视网膜母细胞瘤中枢神经系统转移患儿（CNS转移组）,并依据眼别、年龄、性别选择同期北京同仁医院17例眼外期视网膜母细胞瘤患儿（非CNS转移组）.19例CNS转移组和17例非CNS转移组均在化疗前、化疗中（第3个周期）和化疗后（第6个周期）测定血清神经元特异性烯醇化酶（NSE）和脑脊液的NSE、氯化物、葡萄糖、蛋白定量及白细胞计数的变化,应用Western blot法检测脑脊液LPL蛋白和RT-PCR法检测脑脊液LPL-mRNA的水平.一般资料行两样本t检验,计量数据以均值±标准差表示,行两样本方差分析.结果 CNS转移组CSF-NSE水平明显高于非CNS转移组（F=16.43,P=0.002）;CNS转移组在化疗前血清NSE水平明显高于非CNS转移组（F=41.06,P=0.006）,且CNS转移组化疗前后血清NSE水平变化有统计学意义（F=7.06,P=0.001）.CNS转移组CSF-LPL蛋白明显高于非CNS转移组（F=2.57,P=0.001）,且在化疗前、中、后的脑脊液LPL蛋白表达差异具有统计学意义（F=2.63,P=0.003））.结论 脑脊液LPL蛋白表达水平对视网膜母细胞瘤中枢神经系统转移患儿病情有一定指导意义.

Objective To evaluate the levels of l ipoprotein lipase protein （LPL）and mRNA in cerebrospinal fluid （CSF） for children retinoblastoma （ RB ） and evaluation of the chemotherapy. Methods Case-control study. Total 36 cases were collected in Beijing Tongren Hospital From October 2015 to May 2017. There were two groups, 19 cases of central nervous system（CNS） metastasis and 17 cases of non C NS metastasis according to laterality, age and gender. The changes of neuronspecific enolase （NSE） in serum and cerebrospinal fluid （ CSF）, chloride, glucose and quantitative protein and white blood cell count in CSF were compared between the two groups betbre initiating chemotherapy and after the third and sixth cycles of chemotherapy. LPL expression was assessed by Western blot and RT-PCR. Comparisonsbetweenthetwo groups of general data were performed usingt-test. The measurement data were expressed by mean ＋ standard deviation, and variance analysis was conducted. Results The level of CSF-NSE from CNS metastasis group was significantly higher than non CNS metastasis group（ F = 16.43, P = 0. 002）. The level of serum NSE from CNS metastasis group was significantly higher than non CNS metastasis group before chemotherapy（ F = 41.06 ,P = 0. 006）. There were significant differences in the level of serum NSE in CNS metastasis group before and after chemotherapy （ F = 7.06, P = 0. 001 ）. CSF-LPL protein expression in the CNS metastasis group was significantly higher than that of non CNS metastasis group （ F = 2.57, P = 0. 001 ）. There were significant differences of LPL expression in CNS metastasis group before and after chemotherapy （F = 2.63, P = 0. 003 ） ）. Conclusion The expression of LPL protein in CNS may be related to the progression and chemotherapyof RB with CNS metastasis.