摘要
目的:探析老年骨髓增生异常综合征(MDS)患者血清平均红细胞体积(MCV)、平均血小板体积(MPV)、肿瘤基因(WT-1)的水平及联合检测效能。方法:选取2020年1月-2021年1月邯郸市人民医院收治的100例老年MDS患者作为观察组,及同期80例健康体检者为对照组。检测MCV、MPV、WT-1水平,绘制ROC曲线分析3项指标联合检测在MDS预测中的价值。分析评估MCV、MPV、WT-1在老年MDS患者中的表达及相关性。结果:观察组MCV、MPV、WT-1水平均高于对照组(P<0.001)。Pearson相关性分析显示,MCV水平与MPV、WT-1呈正相关(r=0.724、0.733),MPV与WT-1呈正相关(r=0.731);MCV、MPV、WT-1是老年MDS的独立影响因素(均P<0.05)。3项指标联合检测在老年MDS诊断中的AUC最大(0.873,95%CI:0.776-0.893),敏感度为95.00%,特异度为90.00%,约登指数为0.850,诊断价值显著高于单一指标,比较差异有统计学意义(均P<0.05)。重度患者的MCV、MPV、WT-1水平显著高于轻度患者(均P<0.01)。Logistic回归分析结果显示,MCV、MPV、WT-1高表达是重度老年MDS的影响因素。ROC曲线分析结果显示,MCV、MPV、WT-1联合诊断预测重度老年MDS的AUC最大(0.897,95%CI:0.709-0.926),灵敏度、特异度分别为93.18%、91.07%(P<0.05)。结论:MCV、MPC、WT-1在重度老年MDS中呈高表达状态,此3项指标均可反映受检者的骨髓造血功能状态,但与单一指标检测相比,3项指标联合检测的诊断效果更佳,在老年MDS及病情分期中具有一定优势,推广应用价值更高。
Objective:To investigate the expression levels and combined detection efficiency of serum mean corpuscular volume(MCV),mean platelet volume(MPV),and tumor gene(WT-1)in elderly patients with myelodysplastic syndrome(MDS).Methods:One hundred elderly MDS patients admitted to our hospital from January 2020 to January 2021 were selected as observation group,and eighty healthy subjects during the same period were selected as control group.The levels of MCV,MPV and WT-1 were detected,and receiver operating characteristic(ROC)curve was drawn to analyze the value of combined detection of the three indicators in the prediction of MDS.The expression and correlation of MCV,MPV and WT-1 in elderly patients with MDS were analyzed and evaluated.Results:The levels of MCV,MPV,and WT-1 in the observation group were higher than those in the control group(all P<0.001).Pearson correlation analysis showed that MCV was positively correlated with MPV and WT-1(r=0.724,0.733),while MPV was positively correlated with WT-1(r=0.731).MCV,MPV,and WT-1 were independent influencing factors for elderly MDS(all P<0.05).The combined detection of the three indicators had the largest area under the curve(AUC)(0.873,95%CI:0.776-0.893)in the diagnosis of elderly MDS,with a sensitivity of 95.00%,a specificity of 90.00%,and Youden index of 0.850.The diagnostic value was significantly higher than that of a single indicator(both P<0.05).The levels of MCV,MPV,and WT-1 in severe patients were significantly higher than those in mild patients(all P<0.01).Logistic regression analysis showed that high expression of MCV,MPV,and WT-1 were influencing factors of severe elderly MDS.The ROC curve analysis showed that the combined diagnosis of MCV,MPV and WT-1 had the largest AUC for predicting severe MDS in elderly patients(0.897,95%CI:0.709-0.926),and the sensitivity and specificity were 93.18%and 91.07%,respectively(P<0.05).Conclusion:MCV,MPC,and WT-1 are highly expressed in elderly patients with severe MDS.These three indicators can reflect the bone marrow hematopoietic function status of the subjects.However,compared with single indicator detection,the combined detection of the three indicators is more effective in diagnosis.It has certain advantages in elderly MDS and disease staging,and its promotion and application value is higher.
作者
李焕英
王俊霞
郭菲
程爱花
LI Huan-Ying;WANG Jun-Xia;GUO Fei;CHENG Ai-Hua(Department of Geriatrics,Handan People's Hospital,Handan 056000,Hebei Province,China)
出处
《中国实验血液学杂志》
北大核心
2025年第2期475-480,共6页
Journal of Experimental Hematology
基金
河北省医学科学研究课题(20210782)。
