成人急性淋巴细胞白血病患者血清XCL1、NSE变化及其临床意义

Changes of serum XCL1 and NSE in adult patients with acute lymphoblastic leukemia and their clinical significance

目的探讨成人急性淋巴细胞白血病(ALL)患者血清淋巴细胞趋化因子(XCL1)、神经元特异性烯醇化酶(NSE)变化及其临床意义。方法选取该院2016年1月至2018年6月收治的ALL患者100例作为观察组,另选取同期健康体检者100例作为对照组。治疗后随访2年,根据患者预后结局分为生存组(n=65)与死亡组(n=35)。采用酶联免疫吸附试验(ELISA)检测各组血清XCL1、NSE水平,采用多因素Logistic回归分析影响ALL患者预后的危险因素,应用受试者工作特征(ROC)曲线分析血清XCL1、NSE对ALL患者短期预后的判断价值。结果观察组血清XCL1、NSE水平高于对照组,死亡组血清XCL1、NSE水平高于生存组,差异均有统计学意义(P<0.05)。多因素Logistic回归分析显示,血清XCL1、NSE水平是影响ALL患者预后的重要危险因素(P<0.05)。ROC曲线结果显示,血清XCL1预测ALL患者预后的ROC曲线下面积(AUC)为0.872,敏感度和特异度为0.808和0.758;血清NSE预测患者预后的AUC为0.843,敏感度和特异度为0.769和0.784;联合检测预测患者预后的AUC为0.915,敏感度和特异度为0.865和0.879。结论ALL患者血清XCL1、NSE水平较健康者明显升高,其水平升高与患者的预后不良、生存期短密切相关。联合检测血清XCL1、NSE对评估ALL患者的预后有较高预测价值。

Objective To investigate the changes of serum lymphocyte chemokine 1(XCL1)and neuron-specific enolase(NSE)in adult patients with acute lymphoblastic leukemia(ALL)and their clinical significance.Methods A total of 100 ALL patients admitted to this hospital from January 2016 to June 2018 were selected as the observation group,and another 100 healthy subjects during the same period were selected as the control group.After treatment,the patients were followed up for 2 years,and were divided into survival group(n=65)and death group(n=35)according to their prognosis.Serum XCL1 and NSE levels were detected by enzyme-linked immunosorbent assay(ELISA).Multivariate Logistic regression was used to analyze the risk factors affecting the prognosis of ALL patients.Receiver operating characteristic(ROC)curve was used to analyze the short-term prognosis of serum XCL1 and NSE in ALL patients.Results Serum XCL1 and NSE levels in the observation group were higher than those in the control group,and those in the death group were higher than those in the survival group,with statistical significance(P<0.05).Multivariate Logistic regression analysis showed that serum XCL1 and NSE levels were important risk factors affecting the prognosis of ALL patients(P<0.05).The ROC curve results showed that the area under the ROC curve(AUC)of serum XCL1 in predicting the prognosis of ALL patients was 0.872,and the sensitivity and specificity were 0.808 and 0.758.The AUC,sensitivity and specificity of serum NSE for predicting prognosis were 0.843,0.769 and 0.784.The AUC and sensitivity and specificity of the combined test were 0.915 and 0.865 and 0.879 for predicting prognosis.Conclusion The serum XCL1 and NSE levels in ALL patients are significantly increased,and the increased levels are closely related to the poor prognosis and short survival of patients.Combined detection of serum XCL1 and NSE has a higher predictive value in evaluating the prognosis of ALL patients.