S100A8在儿童急性淋巴细胞白血病预后评估中的意义

Value of S100A8 in evaluating the prognosis of children with acute lymphoblastic leukemia

目的探讨急性淋巴细胞白血病(ALL)患儿S100A8表达与预后的关系。方法回顾性分析CCLG-2008-ALL方案治疗的377例ALL患儿的临床资料。采用ELISA及PCR分别检测患儿血清S100A8蛋白水平及其mRNA的表达,并进行Kaplan-Meier生存分析和Cox回归分析。结果随访56个月,377例患儿总生存率为89.1%。激素诱导良好组患儿S100A8蛋白及mRNA表达水平显著低于激素诱导不良组(P<0.01)。在标危及中危患儿中,S100A8蛋白及mRNA表达水平与患儿的无事件生存率相关(P<0.05)。不同危险度分层患儿的S100A8蛋白及mRNA表达也有明显差异(P<0.01)。发生事件组患儿S100A8蛋白及mRNA表达水平明显高于无事件组(P<0.01)。Kaplan-Meier生存分析和Cox回归模型均提示S100A8过表达是儿童ALL预后的独立危险因素。结论 S100A8高表达可能与儿童ALL不良预后有关,有望作为儿童ALL个体化精准治疗的新参考因子。

Objective To study the association between S100 A8 expression and prognosis in children with acute lymphoblastic leukemia(ALL). Methods The clinical data of 377 children with ALL who were treated with the CCLG-2008-ALL regimen were retrospectively reviewed. ELISA and PCR were used to measure serum protein levels and mRNA expression of S100 A8. The Kaplan-Meier method was used for survival analysis and a Cox regression analysis was also performed. Results The children were followed up for 56 months, and the overall survival rate of the377 children was 89.1%. The prednisone good response group had significantly lower S100 A8 protein and mRNA levels than the prednisone poor response group(P<0.01). In the children with standard or median risk, both S100 A8 protein and mRNA levels were associated with event-free survival rate(P<0.05). There were significant differences in S100 A8 protein and mRNA levels between the children with different risk stratifications(P<0.01). The children who experienced events had significantly higher S100 A8 protein and mRNA levels than those who did not(P<0.01). The Kaplan-Meier survival analysis and the Cox regression model suggested that S100 A8 overexpression was an independent risk factor for the prognosis of children with ALL. Conclusions High S100 A8 expression may be associated with the poor prognosis of children with ALL and is promising as a new marker for individualized precise treatment of children with ALL.