摘要
目的本研究旨在探讨神经母细胞瘤(NB)相关临床及分子生物学特征对中高危NB患儿治疗过程中发生肿瘤进展的预测价值;并分析NB相关肿瘤标记物的监测作用。方法回顾性分析2015年1月-2017年1月就诊于首都医科大学附属北京儿童医院并住院进行治疗的原发病灶位于腹部的中高危NB患儿临床资料。根据治疗过程中是否发生病情进展分为进展组与未进展组,分析NB相关指标在两组患儿间的差异,并通过Logistic回归分析变量与肿瘤进展的关系,寻找预测肿瘤进展的最佳因素。结果 MYCN基因扩增(P=0.001)及首诊时发生骨髓转移(P=0.01)与治疗过程中发生肿瘤进展明显相关,是独立预测因素;此外,当发生肿瘤进展时,经过治疗后已趋于正常的肿瘤标记物水平又会出现急剧上升(P=0.001)。结论 MYCN基因扩增与首诊时发生骨髓转移是中高危NB患儿在治疗过程中发生肿瘤进展的独立预测因素;并且,肿瘤标记物水平变化可提示病情进展,因此在NB诊疗过程中监测肿瘤标志物具有重要意义。
Objective The purpose of this study was to investigate the predictive value of clinical and molecular characteristics in the tumor progression during the treatment of intermediate and high risk neuroblastoma （NB）, and we further analyzed the monitoring value of NB related tumor markers during treatment. Methods Manifestations, images and laboratory datas of intermediate and high risk NB （ primary lesions located in the abdomen） treated in Capital Medical University Affiliated Beijing Children g Hospital from January 2015 to January 2017 were retrospectively studied. Patients were divided into progressive group and non progressive group according to whether the occurrence of disease progression in the treatment process. We analyzed the differences of clinical information, images, tumor markers, and molecular biology characteristics between the two groups. We used Logistic regression to analyze the relationship between variables and tumor progression, and to find the best factors to predict tumor progression. Results MYCN gene amplification （ P = O. 001 ） and bone marrow metastasis （ P = O. 01 ） were significantly related with tumor progression during the treatment process, and they were both independent predictors of progression. In addition, tumor markers elevated sharply when tumor progression occurred. Conclusions MYCN gene amplification and bone marrow metastasis were independent predictors of tumor progression during the treatment process in intermediate and high risk NB. What＇ s more, tumor marker changes may indicate disease progression, monitoring tumor markers at all stages of treatment is of great importance.
作者
杨深
蔡思雨
彭晓霞
马晓莉
秦红
王焕民
YANG Shen;CAI Siyu;PENG Xiaoxia;MA Xiaoli;QIN Hong;WANG Huanmin(Department of Surgical Oncology, Beijing Children＇s Hospital, Capital Medical University, National Center for Childreng Health, Beijing 100045, China)
出处
《中国小儿血液与肿瘤杂志》
CAS
2018年第2期62-68,共7页
Journal of China Pediatric Blood and Cancer
