成人急性淋巴细胞白血病患者血清SALL4、Flt3L变化及其临床意义-东南大学学报医学版

成人急性淋巴细胞白血病患者血清SALL4、Flt3L变化及其临床意义

单位：1. 福建医科大学福总临床医学院心胸外科, 福建福州 350025;
2. 福建医科大学福总临床医学院血液科, 福建福州 350025;
3. 福建协和医院急诊科, 福建福州 350025

分类号：R733.71

出版年·卷·期（页码）：2025·44·第三期（493-498）

摘要：

目的: 探究成人急性淋巴细胞白血病(ALL)患者血清婆罗双树样基因-4(SALL4)、FMS样酪氨酸激酶3配体(Flt3L)变化及其临床意义。方法: 本研究选择2021年10月至2023年10月在院就诊的成人ALL患者86例作为研究组,同时,选择同期健康志愿者86例作为对照组。根据ALL患者预后情况分为预后不良组21例、预后良好组65例。采用ELISA测定血清SALL4、Flt3L表达水平;Logistic回归分析影响ALL患者预后的因素;绘制ROC曲线分析血清SALL4、Flt3L水平对ALL预后的预测价值。结果: 与对照组相比,研究组血清SALL4水平升高(P＜0.05),Flt3L水平降低(P＜0.05)。与预后良好组相比,预后不良组血清SALL4水平升高(P＜0.05),Flt3L水平降低(P＜0.05)。Logistic回归分析结果显示,血清SALL4、Flt3L是影响ALL患者预后的因素(P＜0.05)。血清SALL4、Flt3L二者联合预测ALL患者预后的AUC最高为0.971,优于各自单独预测(Z_二者_联合-SALL4=2.839、P=0.005,Z_{二者联合-Flt3L}=2.201、P=0.028),敏感度为95.24%,特异度为89.23%。结论: ALL患者血清SALL4水平升高,Flt3L水平降低,二者联合预测ALL患者预后的效能更好。

Objective: To investigate the changes and clinical significance of levels of serum Sal-like protein 4(SALL4) and FMS-like tyrosine kinase 3 ligand(Flt3L) in adult patients with acute lymphoblastic leukemia(ALL). Methods: 86 adult ALL patients who visited our hospital from October 2021 to October 2023 were selected as the research group. Meantime, 86 healthy volunteers in our hospital were selected as the control group. According to the prognosis of ALL patients, 21 patients were divided into poor prognosis group and 65 patients with good prognosis group. ELISA was applied to measure the expression levels of serum SALL4 and Flt3L. Logistic regression analysis of prognostic factors of ALL patients was done. ROC curves were plotted to analyze the predictive value of serum SALL4 and Flt3L levels for the prognosis of ALL. Results: Compared with the control group, the serum SALL4 level in the research group was higher(P<0.05), and the Flt3L level was lower(P<0.05). Compared with the good prognosis group, the poor prognosis group had higher serum SALL4 level(P<0.05) and lower Flt3L level(P<0.05). Logistic regression analysis results showed that serum SALL4 and Flt3L were the prognostic factors of ALL patients(P<0.05). The combination of serum SALL4 and Flt3L had the highest AUC (0.971)in predicting the prognosis of ALL patients, which was better than individual prediction(Z_{combination-SALL4}=2.839, P=0.005; Z_{combination-Flt3L}=2.201, P=0.028), with a sensitivity of 95.24% and a specificity of 89.23%. Conclusion: Serum SALL4 level is elevated and Flt3L level is reduced in ALL patients. The combination of the two is more effective in predicting the prognosis of ALL patients.

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