乳酸脱氢酶同工酶-5和β2-微球蛋白在弥漫大B细胞淋巴瘤诊断及疗效评估中的应用

Study on the application of LDH-5 and β2-MG in the diagnosis and efficacy assessment of diffuse large B-cell lymphoma

目的 :分析乳酸脱氢酶同工酶-5(LDH-5)和β2-微球蛋白(β2-MG)在弥漫大B细胞淋巴瘤(DLBCL)的诊断及疗效评估中的应用价值。方法 :选取2020年6月至2023年1月福建医科大学肿瘤临床医学院收治的87例DLBCL患者作为研究组,以同期在同一医院门诊体检的120名健康人作为对照组,分析对照组与研究组以及研究组不同临床病理特征患者间LDH-5和β2-MG表达情况,绘制受试者工作特征(ROC)曲线分析LDH-5和β2-MG水平对DLBCL的诊断价值;使用Spearman相关分析方法分析LDH-5和β2-MG与DLBCL患者治疗有效率的相关性。结果 :研究组LDH-5和β2-MG水平明显高于对照组(P <0.05)。87例患者中治疗有效72例,无效15例。LDH-5和β2-MG水平联合检测诊断DLBCL的敏感性、特异性、准确性及ROC曲线下面积(AUC;95%CI)值分别为0.944、0.922、0.931及0.876(0.641-0.910),均显著高于单一指标的诊断价值(P <0.05)。Ann Arbor分期为Ⅲ~Ⅳ期、有骨髓浸润、治疗反应为无效、国际预后指数(IPI)评分为高危者LDH-5和β2-MG水平均分别明显高于Ann Arbor分期为Ⅰ~Ⅱ期、无骨髓浸润、治疗反应为有效、IPI评分为低危者(P <0.05)。Pearson分析结果显示,LDH-5和β2-MG水平均与DLBCL患者治疗有效率呈负相关(P <0.05)。结论:LDH-5和β2-MG在DLBCL患者中呈高表达水平状态,联合检测上述两个指标可提升单一指标对DLBCL患者的诊断价值,为患者预后和疗效评估提供临床参考。

Objective:To analyze the application value of lactate dehydrogenase-5(LDH-5)and β2-microglobulin(β2-MG)in the diagnosis and efficacy assessment of diffuse large B-cell lymphoma(DLBCL).Methods:Eighty-seven DLBCL patients admitted to Clinical College of Oncology,Fujian Medical University from June 2020 to January 2023 were selected as the study group,and 120 healthy people who underwent physical examination in the outpatient department of the same hospital during the same period were selected as the control group.The expression of LDH-5 and β2-MG between the control group and the study group as well as patients with different clinicopathological characteristics of the study group were analyzed,and the receiver operating characteristic(ROC)curve was drawn to analyze the diagnosis value of LDH-5 and β2-MG levels in DLBCL.Spearman correlation analysis was used to analyze the correlation between LDH-5 and β2-MG and the response rate of DLBCL patients.Results:The levels of LDH-5 and β2-MG in the study group were significantly higher than those of the control group(P<0.05).Treatment was effective in 72 of the 87 patients and ineffective in 15.The sensitivity,specificity,accuracy,and area under ROC curve(AUC,95%CI)values of the combined detection of LDH-5 and β2-MG levels for diagnosing DLBCL were 0.944,0.922,0.931,and 0.876(0.641-0.910),respectively,which were significantly higher than those of single indicator detection(P<0.05).The levels of LDH-5 and β2-MG in Ann Arbor stageⅢtoⅣ,with bone marrow infiltration,ineffective treatment response,and international prognostic index(IPI)score at high risk were significantly higher than those in Ann Arbor stageⅠtoⅡ,without bone marrow infiltration,effective treatment response,and low risk IPI score,respectively(P<0.05).The results of Pearson analysis showed that LDH-5 and β2-MG levels were negatively correlated with the treatment efficacy of DLBCL patients(P<0.05).Conclusions:LDH-5 and β2-MG levels are highly expressed in DLBCL patients,and the combined detection of the above indexes can enhance the diagnosis value of DLBCL patients and provide clinical reference for the assessment of the prognosis and efficacy.