Objective: To analyze the expression level of the serum soluble E cadherin (SE-CAD) and Matriptase and its clinical significance for evaluation of the disease condtions and prognosis in patients with acute myeloid leukemia (AML).
Methods: One hundred and ten patients diagnosed as AML in our hospital were divided into 3 groups: newly diagnosed group (38 cases), remission group (40 cases) and recurrence group (32 cases). The expression levels of serum matriptase were detected by Western blot, and the expression levels of serum SE-CAD were detected by ELISA. The serum levels of serum SE-CAD and matriptase among 3 groups were compared. Followin-up for one year, according to the outcome of patients, all the patients were divided into 2 groups: the survival group and death group. The serum levels of SE-CAD and Matriptase were compared between 2 groups. The correlation of serum levels of SE-CAD and matriptase with the survival of AML patients was analyzed by multivariate Logistic analysis. The evaluation value of the serum levels of SE-CAD and matriptase for the prognosis of the patients with AML were analyzed by receiver operating characteristic curves (ROC).
Results: The serum levels of SE-CAD and matriptase were siginificantly different among 3 groups (P＜0.05). The serum levels of SE-CAD and matriptase in remission group were lowest (P＜0.05), and the serum levels of SE-CAD and matriptase were not different between newly diagnoses and recurrence groups (P＞0.05). Multivariate Logistic analysis showed that the serum levels of SE-CAD and matriptase were independent risk factors for the prognosis of AML patients (OR=3.157, P＜0.05, OR=2.426, P＜0.05). By follow-up for 1 year, the serum expression levels of SE-CAD and Matriptase in survival group were lower than that in death group. ROC curve showed that when the cut-off value of matriptase level was 0.73 and SE-CAD level was 3.42 ng/ml, the AUC of predictions for the poor prognosis in AML patients was 0.849 (P＜0.05), the sensitivity was 85.6% (95%CI: 0.810~0.924) and specificity was 89.6% (95%CI: 0.849~0.941).
Conclusion: The serum levels of SE-CAD and matriptase can perfectly evaluate the condition and short-term prognosis of the patients with AML.
题目: 血清SE-CAD与Matriptase在急性髓系白血病患者中的表达水平及其临床意义.
目的: 通过分析急性髓系白血病(AML)患者血清可溶性E钙粘蛋白（SE-CAD）与Matriptase表达水平，评估2种指标联合检测对患者病情及预后的预测价值.
方法: 将我院治疗的110例AML患者分为：初治组（38例）、缓解组（40例）和复发组（32例）。收集3组患者骨髓标本，应用Western blot法检测Matriptase表达水平，应用酶联免疫吸附试验（ELISA）检测血清SE-CAD水平。随访一年，根据预后结局分为：生存组与死亡组，比较2组Matriptase及血清SE-CAD表达水平。应用多元Logistic回归分析Matriptase及血清SE-CAD表达水平与生存率的相关性。绘制受试者工作特征曲线（ROC）评估Matriptase联合血清SE-CAD检测对AML患者短期预后的判断价值.
结果: 3组AML患者的血清Matriptase及SE-CAD表达水平均存在显著差异（均P＜0.05）；其中缓解组血清Matriptase及SE-CAD表达水平最低（P＜0.05），初治组与复发组之间无显著差异（P＞0.05）。多元Logistic回归分析显示，Matriptase（OR=3.157，P=0.016）及血清SE-CAD（OR=2.426，P=0.027）表达水平是影响AML患者预后的危险因素。随访一年，死亡组血清Matriptase及SE-CAD表达水平均显著高于生存组（P＜0.05)。ROC曲线显示，血清Matriptase截断值为0.73及SE-CAD截断值为3.42 ng/ml，预测AML患者预后不良发生的AUC为0.849（P=0.029），灵敏度为85.6%（95%CI：0.810～0.924），特异度为89.6%（95%CI：0.849～0.941）.
结论: 血清Matriptase及SE-CAD联合检测能较好地评估AML患者的病情及短期预后.