Chen Ze, Cai Zhi-Mei, Zhao Li-Dong, Wang Ying
Department of Hematology,The First People's Hospital of Lianyungang, Lianyungang 222002, Jiangsu Province, China. E-mail:
Department of Hematology,The First People's Hospital of Lianyungang, Lianyungang 222002, Jiangsu Province, China.
Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2017 Dec;25(6):1636-1640. doi: 10.7534/j.issn.1009-2137.2017.06.010.
To evaluate the clinical value of combined detection of BCL-2 and PD-L1 in predicting the prognosis of newly diagnosed patients with acute leukemia (AL).
A total of 100 cases of AL in our hospital from Jan. 2013 to Sep. 2016 were enrolled in the study. The mRNA expression of BCL-2 and PD-L1 in peripheral blood of patients was detected by RT-PCR, and the prognosis of the patients was followed up. According to the follow-up results, these patients were divided into complete remission group and no remission group, the statistical analysis of different indexes predicting the prognosis was performed.
Compared with the healthy control group, the positive rates of BCL-2 and PD-L1 in the bone marrow specimens of AL patients significantly increased (P<0.01). The BCL-2 predicting the prognosis of patients showed that the area under the curve (AUC) was 0.725(P=0.006), the diagnostic threshold was 1.550, the sensitivity(Sen) and specificity(Spe) were 72% and 84%, respectively. The single PD-L1 detection for predicting the prognosis of patients showed that AUC was 0.740 (P=0.004), diagnostic threshold was 12.500, Sen and Spe were 66.7% and 73.1%, respectively. The diagnostic index of combined detection was 77.90, which were higher than that of series detection 54.75, and higher than that of the independent diagnostic index.
Detection of BCL-2 combined with PD-L1 can be used to evaluate the prognosis of patients with newly diagnosed acute leukemia, which can improve the specificity and sensitivity of the detection, and has higher clinical diagnostic value than single actection.
评估联合检测BCL-2和PD-L1对新诊断急性白血病（AL）患者预后的预测价值。
选取2013年1月至2016年9月我院收治的100例AL患者纳入研究。采用RT-PCR法检测患者外周血中BCL-2和PD-L1的mRNA表达水平，并对患者进行随访。根据随访结果，将患者分为完全缓解组和未缓解组，对不同指标预测预后情况进行统计学分析。
与健康对照组相比，AL患者骨髓标本中BCL-2和PD-L1的阳性率显著升高（P<0.01）。BCL-2预测患者预后的曲线下面积（AUC）为0.725（P=0.006），诊断阈值为1.550，敏感度（Sen）和特异度（Spe）分别为72%和84%。单独检测PD-L1预测患者预后的AUC为0.740（P=0.004），诊断阈值为12.500，Sen和Spe分别为66.7%和73.1%。联合检测的诊断指数为77.90，高于串联检测的54.75，且高于独立诊断指数。
联合检测BCL-2与PD-L1可用于评估新诊断急性白血病患者的预后，可提高检测的特异度和敏感度，较单项检测具有更高的临床诊断价值。
