摘要
目的探讨急性淋巴细胞性白血病(ALL)患儿诊断时胞质糖皮质激素受体(GR)表达水平与疗效的相关性,探讨GR能否作为判断儿童ALL预后的因素之一。方法2005年8月1日-2007年9月30日,本院利用GR单克隆抗体,通过流式细胞仪检测147例初治ALL患儿诊断时骨髓液单个核细胞GR表达水平,并进行临床资料追踪,应用SPSS 13.0软件分析GR表达水平与疾病各治疗阶段疗效的相关性。结果147例患儿治疗后缓解(CR)143例,12例复发。ALL患儿起病时GR表达水平与泼尼松窗口治疗结果是否敏感无相关性(F=1.769 P=0.174);与诱导治疗第19天骨髓检查结果无相关性(F=0.411 P=0.664);与诱导治疗结果是否获得疾病缓解无相关性(t=1.670 P=0.096);与疾病获得缓解时按微小残留病(MRD)水平分组无相关性(F=2.040 P=0.134);与临床随访中疾病处于缓解状态或复发无相关性(t=1.471 P=0.143);但与疾病治疗失败(诱导治疗不缓解和疾病复发)有相关性(t=2.128 P=0.035)。在随访时间超过1 a的75例患儿中(中位随访时间17个月),9例复发,患儿起病时GR表达水平与疾病的长期持续缓解或复发无相关性(t=1.848 P=0.069)。结论GR尚不能作为独立判断疾病预后的因素,但有可能作为指导治疗的指标之一。
Objective To study the relationship between initial expression level of glucocorticoid receptor （GR） and curative effect in children with acute lymphoblastic leukemia （ALL） in children, and to evaluate whether initial GR expression levels can be the prognostic factor for children with ALL. Methods From 1 Aug. 2005 to 30 Sep. 2007, GR monoclonal antibody was used to measure the cellular GR expression levels in bone marrow samples from 147 newly diagnosed children with ALL by flow cytometry, and the clinical data were collected and followed up. SPSS 13.0 software was used to analyze the relationship between the clinical outcome and initial GR expression level. Results Of the 147 patients, 143 patients had complete remission （CR） , 12 patients had relapse ＇afterwards. Initial GR expression level of the patients had no association with initial prednisone therapy response （ F = 1. 769 P = 0. 174 ）, neither with bone marrow smear results on the 19^th day（F=0.411 P=0.664）, the CR rate after induction therapy（t = 1. 670 P =0.096） ,nor the minimal residual disease （MRD） level after induction therapy（ F = 2. 040 P = 0. 134） and the relapse rate in the follow - up（ t = 1. 471 P = 0. 143 ）. In 75 patients who had more than 1 year＇s follow - up （the median follow up time was 17 months after CR） , 9 patients developed disease relapse, but the initial GR expression level had no relationship with the relapse rate （ t = 1. 848 P = 0. 069）. However,initial GR expression level did not have associations with the therapy failure （ including induction therapy failure and disease relapse） （ t = 2. 128 P = 0. 035 ）. Conclusion The initial GR expression level could not be the independent prognostic factor for children with ALL, which may be a factor to guide treatment.
出处
《实用儿科临床杂志》
CAS
CSCD
北大核心
2008年第15期1157-1159,共3页
Journal of Applied Clinical Pediatrics
基金
上海市重点学科建设项目资助(T0204)
