摘要
目的探讨24 h尿香草扁桃酸(VMA)、神经元特异性烯醇化酶(NSE)、乳酸脱氢酶(LDH)、血清铁蛋白(SF)及C-反应蛋白(CRP)在儿童神经母细胞瘤(NB)的诊断及疗效评估中的作用。方法对33例确诊为NB患儿的临床资料进行回顾性分析,应用高效液相色谱仪通过化学比色法测定24 h尿VMA;采用放射免疫法检测血清NSE和SF;应用全自动生化分析仪通过速率法测定血清LDH;采用固相免疫双抗体夹心法测定血CRP。分析以上患儿在初诊时5种肿瘤标记物的阳性率,对比初诊与化疗2个疗程后各指标的检测值;对比出现疾病进展的10例患儿在初诊、化疗2疗程后及进展时各标记物的检测值,并对比分析进展患儿与未进展患儿的检测值。结果初诊时5种肿瘤标记物阳性率均在65%以上,其中24 h尿VMA阳性率最高,达92.3%,其次为NSE,阳性率83.6%,LDH、SF及CRP阳性率分别为82.2%、75.6%及67.9%。经2个疗程化疗后,尿VMA、NSE、LDH及SF水平均初诊时明显下降(P<0.01)。在出现疾病进展时,尿VMA、NSE、LDH及SF较化疗2疗程后均升高(P<0.01),且均高于正常值,而疾病进展组的尿VMA、NSE、LDH明显高于未进展组(P<0.01)。结论 5种肿瘤标记物VMA、NSE、SF、LDH及CRP联合检测对NB早期诊断及评价疗效有一定价值。
Objective To investigate the function of the combined detection of urinary vanillylmandelic acid （VMA）, serum neuron-specific enolase （NSE）, serum ferritin （SF）, lactate dehydrogenase （LDH） and C-reactive protein （CRP） in the early diagnosis and therapeutic evaluation of patients with neuroblastoma （NB）. Methods Thirty three patients with NB admitted in Beijing Children＇s Hospital were analyzed retrospectively. Twenty-four-hour urinary VMA was measured by high performance liquid chromatography; serum NSE and SF were detected by radioimmunoassay; LDH was measured by automated clinical chemistry analyzer; CRP was measured by solid-phase immunoassay double antibody sandwich method. The positive rates at newly diagnosis and different stages of the disease, as well as the tumor-marker levels before and after chemotherapy were analyzed. The tumor-marker levels at newly diagnosis, 2 cycles after chemotherapy and aggression period were compared in 10 patients who occurred tumor aggression. Results The positive rates of these 5 tumor markers were all above 65% at newly diagnosis （92. 3% for VMA, 83.6% for NSE, 82.2% for LDH, 75.6% for SF and 67.9% for CRP）. After 2 cycles of chemotherapy, the levels of these 5 tumor markers were declined （P 〈0. 01）. When the patients occurred tumor aggression, 4 tumor markers including urinary VMA, NSE, LDH and SF were elevated above the normal levels （P 〈 0. 01 ）. Besides, urinary VMA, NSE and LDH in aggression patients were obviously higher than those in non-aggression patients （P 〈 0.01 ）. Conclusions The combination of tumor-marker detection is helpful for the early diagnosis and evaluation of therapeutic effect in the patients with NB.
出处
《中国小儿血液与肿瘤杂志》
CAS
2013年第2期65-68,85,共5页
Journal of China Pediatric Blood and Cancer
