摘要
目的 探讨儿童急性淋巴细胞白血病(ALL)血清糖基磷脂酰肌醇锚附着蛋白1(GPAA1)和Endocan mRNA表达及临床意义。方法 选取2018年1月—2021年1月宁夏医科大学总医院儿内科收治ALL患儿86例为ALL组,根据1年后是否复发分为未复发亚组70例与复发亚组16例,另选取医院同期体检健康儿童54例为健康对照组,采用qPCR法检测血清GPAA1、Endocan mRNA表达。采用Pearson相关性分析ALL患儿血清GPAA1 mRNA与Endocan mRNA表达的相关性,多因素Logistic回归分析ALL患儿复发的影响因素,受试者工作特征曲线(ROC)分析血清GPAA1、Endocan mRNA表达对ALL患儿复发的预测价值。结果 ALL组血清GPAA1、Endocan mRNA表达高于健康对照组(t=13.375、17.485,P均<0.001)。复发亚组血清GPAA1、Endocan mRNA表达水平高于未复发亚组(t=4.069、3.791,P均<0.001)。Pearson相关性分析显示,血清GPAA1 mRNA表达与Endocan mRNA表达呈正相关(r=0.564,P<0.001)。多因素Logistic回归分析显示,免疫表型T-ALL、WBC≥50×10~9/L、混合谱系白血病重排、危险度分型中高危及血清GPAA1、Endocan mRNA高表达为ALL患儿复发的独立危险因素[OR(95%CI)=1.958(1.612~4.748)、1.465 (1.076~1.995)、1.979 (1.094~3.581)、2.854 (2.327~5.916)、1.512 (1.054~2.170)、2.133 (1.080~4.214)]。ROC曲线分析显示,血清GPAA1、Endocan mRNA表达及二者联合预测ALL患儿复发的曲线下面积(AUC)分别为0.786、0.784、0.866,二者联合预测ALL患儿复发的AUC大于单独预测(Z=2.574、2.919,P=0.010、0.004)。结论 儿童ALL血清GPAA1、Endocan mRNA表达上调,为ALL患儿复发的独立危险因素,可作为ALL患儿复发的预测指标。
Objective To investigate the expression and clinical significance of glycosylphosphatidylinositol anchored protein 1(GPAA1) and Endocan mRNA in children with acute lymphoblastic leukemia(ALL).Methods Eighty-six children with ALL who were admitted to the Department of Pediatrics of the General Hospital of Ningxia Medical University from January 2018 to January 2021 were selected as the ALL group.They were divided into 70 non relapse subgroups and 16 relapse subgroups according to whether they recurred one year later.In addition,54 healthy children who were examined at the same time in the hospital were selected as the healthy control group.The expression of serum GPAA1 and Endocan mRNA was detected by qPCR method.Pearson correlation analysis was used to analyze the correlation between the expression of serum GPAA1 mRNA and Endocan mRNA in children with ALL,multifactor logistic regression analysis was used to analyze the factors affecting the recurrence of children with ALL,and the predictive value of serum GPAA1 and Endocan mRNA expression on the recurrence of children with ALL was analyzed by the subject’s work characteristic curve(ROC).Results The expression of GPAA1 and Endocan mRNA in serum of ALL group was higher than that of healthy control group(t=13.375,17.485,P<0.001).The expression levels of serum GPAA1 and Endocan mRNA in the recurrent subgroup were higher than those in the non-recurrent subgroup(t=4.069,3.791,P<0.001).Pearson correlation analysis showed that the expression of GPAA1 mRNA in serum was positively correlated with that of Endocan mRNA(r=0.564,P<0.001).Multivariate logistic regression analysis showed that the immune phenotype T-ALL and WBC ≥ 50×10~9/L,mixed lineage leukemia rearrangement,middle and high risk of risk classification,and high expression of serum GPAA1 and Endocan mRNA were independent risk factors for relapse in children with ALL [OR(95%CI)=1.958(1.612-4.748),1.465(1.076-1.995),1.979(1.094-3.581),2.854(2.327-5.916),1.512(1.054-2.170),2.133(1.080-4.214)].ROC curve analysis showed that the area under the curve(AUC) of serum GPAA1,Endocan mRNA expression and their combined prediction of relapse in children with ALL were 0.786,0.784 and 0.866,respectively.The AUC of the combined prediction of relapse in children with ALL was greater than that of the single prediction(Z=2.574,2.919,P=0.010,0.004).Conclusion The up-regulated expression of serum GPAA1 and Endocan mRNA in children with ALL is an independent risk factor of relapse in ALL children,and can be used as a predictor of relapse in ALL children.
作者
卫雪利
费英山
张银娟
刘静
马金海
Wei Xueli;Fei Yingshan;Zhang Yinjuan;Liu Jing;Ma Jinhai(Department of Pediatrics,General Hospital of Ningxia Medical University,Ningxia Province,Yinchuan 750003,China;不详)
出处
《疑难病杂志》
CAS
2022年第10期1075-1080,共6页
Chinese Journal of Difficult and Complicated Cases
基金
宁夏回族自治区自然科学基金(2018AAC02143)。
