脑脊液与血清IGF-1、IGF-2、IGFBP-3、IL-2、IL-6、IL-8在急性淋巴细胞性白血病中的表达水平及意义

Expression and significance of cerebrospinal fluid and serum IGF-1,IGF-2,IGFBP-3,IL-2,IL-6,IL-8 in acute lymphocytic leukemia

目的探析脑脊液与血清胰岛素样生长因子(IGF)-1、IGF-2、胰岛素样生长因子结合蛋白(IGFBP)-3、白细胞介素(IL)-2、IL-6、IL-8在急性淋巴细胞性白血病(ALL)中的表达水平及意义。方法收集南阳市第二人民医院2017年1月-2020年1月收治的ALL患者100例(观察组),基于中国儿童白血病协作组(CCLG)-2008-ALL方案危险分层,分为标危组(n=27),中危组(n=41),高危组(n=32),另收集健康体检中心同期体检者35名(健康对照组),检测脑脊液与血清IGF-1、IGF-2、IGFBP-3、IL-2、IL-6、IL-8水平。结果观察组脑脊液IGF-1、IGF-2、IGFBP-3、IL-6、IL-8水平明显高于健康对照组,脑脊液IL-2明显低于健康对照组,差异有统计学意义(P<0.05)。ALL患者不同危险分层比较,标危组、中危组、高危组脑脊液IGF-1、IGF-2、IGFBP-3、IL-6、IL-8水平呈不断升高趋势,IL-2水平呈降低趋势,各亚组比较差异有统计学意义(P<0.05)。观察组血清IGF-2、IL-6、IL-8水平明显高于健康对照组,血清IGF-1、IGFBP-3、IL-2明显低于健康对照组,差异有统计学意义(P<0.05)。ALL患者不同危险分层比较,标危组、中危组、高危组血清IGF-2、IL-6、IL-8呈不断升高趋势,血清IGF-1、IGFBP-3、IL-2水平呈降低趋势,各亚组比较差异有统计学意义(P<0.05)。Logistic回归分析,脑脊液、血清IGF-1、IGF-2、IGFBP-3、IL-2、IL-6、IL-8指标均与ALL密切相关(P<0.05)。结论 ALL患者脑脊液及血清IGF-1、IGF-2、IGFBP-3、IL-2、IL-6、IL-8水平呈异常状态,且与ALL危险分层密切相关,有效反映ALL状况及病情变化。

Objective To explore cerebrospinal fluid(CSF) and serum insulin-like growth factor(IGF)-1,IGF-2,insulinlike growth factor binding protein(IGFBP)-3,interleukin(IL)-2,IL-6,IL-8 expression and significance in acute lymphocytic leukemia(ALL).Methods 100 cases of ALL patients(observation group) admitted to the Nanyang Second People’s Hospital from January 2017 to January 2020 were collected,and divided into subgroups based on the staging system of malignant lymphoma,risk group(n=27),mid-risk group(n=41) and high-risk group(n=32),another 35 patients(healthy control group) from the same period in the health examination center were collected to detect cerebrospinal fluid and serum IGF-1,IGF-2,IGFBP-3,IL-2,IL-6,IL-8 level.Results The levels of cerebrospinal fluid IGF-1,IGF-2,IGFBP-3,IL-6 and IL-8 in the observation group were significantly higher than those in the healthy control group,and the cerebrospinal fluid IL-2 was significantly lower than that in the healthy control group.The difference was statistically significant(P<0.05).Compared with different stages of ALL patients,the levels of CSF IGF-1,IGF-2,IGFBP-3,IL-6,IL-8 in patients with risk group,mid-risk group,and high-risk group showed a rising trend.There was a decreasing trend in the level of IL-2,and there was a statistically significant difference between the subgroups(P<0.05).Serum IGF-2,IL-6 and IL-8 levels in the observation group were significantly higher than those in the healthy control group,and serum IGF-1,IGFBP-3 and IL-2 levels were significantly lower than the healthy control group,the difference was statistically significant(P<0.05).Compared with the different stages of ALL patients,the serum IGF-2,IL-6,IL-8 in patients with risk group,midrisk group,and high-risk group showed a rising trend,and the levels of serum IGF-1,IGFBP-3,IL-2 showed a decrease trend;the difference between the subgroups was statistically significant(P<0.05).Logistic regression analysis showed that the indexes of cerebrospinal fluid,serum IGF-1,IGF-2,IGFBP-3,IL-2,IL-6 and IL-8 were closely related to ALL(P<0.05).Conclusion The CSF and serum IGF-1,IGF-2,IGFBP-3,IL-2,IL-6 and IL-8 levels of ALL patients were abnormal,and closely related to the ALL stage,which effectively reflected the changes in ALL status and condition.