中枢神经系统性白血病患者血清S100-β蛋白和CRP水平及临床意义

Expression levels and clinical significance of S100-βprotein and C-reactive protein in serum of patients with central nervous system leukemia

目的探讨中枢神经特异性蛋白(S100-β蛋白)和C反应蛋白(CRP)在中枢神经系统性白血病(CNSL)患者血清中的水平及临床意义。方法选取于该院肿瘤内科就诊的50例CNSL患者纳入观察组,另选取同期于该院就诊的50例急性白血病无中枢神经系统损害患者纳入对照组,采集两组空腹静脉血4 mL,采用双抗体夹心法检测血清S100-β蛋白水平,采用胶乳增强免疫比浊法检测血清CRP水平。比较两组治疗前血清S100-β蛋白及CRP水平;比较CNSL患者治疗前后血清S100-β蛋白及CRP水平;分析CNSL患者治疗后缓解者与未缓解者血清S100-β蛋白及CRP水平变化;绘制受试者工作特征(ROC)曲线,分析血清S100-β蛋白及CRP诊断CNSL的临床价值。结果与对照组比较,观察组患者治疗前血清S100-β蛋白及CRP水平明显升高,差异均有统计学意义(P<0.05)。治疗后1个月,CNSL患者血清S100-β蛋白及CRP水平明显低于治疗前,差异均有统计学意义(P<0.05)。治疗后,缓解组血清S100-β蛋白及CRP水平明显低于未缓解组,差异均有统计学意义(P<0.05)。ROC曲线分析显示,S100-β蛋白诊断CNSL的曲线下面积(AUC)为0.903(95%CI:0.603~0.927,P<0.05),约登指数为0.8477,灵敏度为93.42%,特异度为91.35%;CRP诊断CNSL的AUC为0.857(95%CI:0.579~0.887,P<0.05),约登指数为0.7955,灵敏度为89.36%,特异度为90.19%。结论S100-β蛋白和CRP在CNSL患者血清中呈高表达,可作为CNSL患者临床诊断及预后评估的有效指标。

Objective To investigate the expression levels and clinical significance of central nervous system(CNS)-specific protein(S100-βprotein)and C-reactive protein(CRP)in the serum of the patients with CNS leukemia(CNSL).Methods Fifty patients with CNSL treated in the oncology department of the Foshan Municipal Hospital of Traditional Chinese Medicine were selected as the observation group.Contemporaneous other 50 patients with acute leukemia without CNS damage treated in this hospital were selected as the control group.4 mL of fasting venous blood was collected from the two groups,the serum S100-βprotein level was detected by adopting the double antibody sandwich method,and the serum CRP level was detected by adopting the latex-enhanced immune turbidimetric method.The S100-βprotein and CRP levels were compared between the two groups before treatment.The serum S100-βprotein and CRP levels in CNSL patients before and after treatment were compared.The changes of serum S100-βprotein and CRP levels after treatment in the remission patients and non-remission patients in the CNSL patients were analyzed.The receiver operating characteristic(ROC)curve was drawn.Then the clinical value of serum S100-βprotein and CRP for diagnosing CNSL was analyzed.Results Compared with the control group,the expression levels of serum S100-βprotein and CRP in the observation group were significantly increased before treatment,and the differences were statistically significant(P<0.05).After 1-month treatment,the levels of serum S100-βprotein and CRP in CNSL patients were significantly lower than those before treatment,and the differences were statistically significant(P<0.05).After treatment,the levels of serum S100-βprotein and CRP in the remission group were significantly lower than those in the non-remission group,and the differences were statistically significant(P<0.05).The ROC curve analysis showed that the area under the curve(AUC)of S100-βprotein for diagnosing CNSL was 0.903(95%CI:0.603-0.927,P<0.05),the Jordan index was 0.8477,the sensitivity was 93.42%,and the specificity was 91.35%.AUC of CRP for diagnosing CNSL was 0.857(95%CI:0.579-0.887,P<0.05),the Jordan index was 0.7955,the sensitivity was 89.36%,and the specificity was 90.19%.Conclusion S100-βprotein and CRP are highly expressed in the serum of CNSL patients,which can be used the effective indicators for clinical diagnosis and prognosis evaluation of CNSL patients.