Chai Yu-Jie, Lu Na-Dan, Li Ping, Su Shu-Fang, Wei Hui-Xia, Xu Yan, Wang Dao
Department of Pediatrics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China.
Henan Provincial Children's Hematological Cancer Disease Diagnosis and Treatment Center, Zhengzhou 450052, Henan Province, China.
Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2024 Oct;32(5):1566-1570. doi: 10.19746/j.cnki.issn.1009-2137.2024.05.041.
To explore the value of REG3α, sST2 and TNFR1 in peripheral blood for risk stratification and prognostic evaluation of acute graft-versus-host disease (aGVHD) after allogeneic hematopoietic stem cell transplantation (allo-HSCT) in children.
From January 2020 to March 2022, 70 children with aGVHD after allo-HSCT in the First Affiliated Hospital of Zhengzhou University were selected as the research objects, of which 50 cases were mild aGVHD (grade I-II) and 20 cases were severe aGVHD (grade III-IV). 30 healthy children who underwent physical examinations in our hospital during the same period were selected as the control group. Luminex platform was used to detect the protein expression levels of REG3α, sST2 and TNFR1 during aGVHD occurrence, and the differences between the three groups were analyzed by one-way ANOVA. According to the outcome of aGVHD treatment within 28 days, the patients were divided into a good prognosis group of 58 cases and a poor prognosis group of 12 cases. The ROC curve was used to analyze the value of REG3α, sST2 and TNFR1 in predicting the prognosis of children with aGVHD.
The peripheral blood levels of REG3α, sST2 and TNFR1 in the mild aGVHD and severe aGVHD groups were significantly higher than those in the control group ( <0.05), and those in the severe aGVHD group were significantly higher than those in the mild aGVHD group ( <0.05). Compared with the good prognosis group, the peripheral blood levels of REG3α, sST2 and TNFR1 in the poor prognosis group were significantly higher ( =9.27,3.33,2.97; <0.01). ROC curve analysis showed that the area under the curve (AUC), sensitivity and specificity of the combined detection of REG3α, sST2 and TNFR1 in predicting the prognosis of children with aGVHD were higher than those of the above indicators detected alone or in pairs.
The expression levels of REG3α, sST2 and TNFR1 were related to the severity of aGVHD. The combination of REG3α, sST2 and TNFR1 has a high clinical value in predicting the prognosis of children with aGVHD, which is expected to provide a reliable reference for clinical evaluation of the prognosis of children with aGVHD.
探讨外周血中REG3α、sST2和TNFR1在儿童异基因造血干细胞移植（allo-HSCT）后急性移植物抗宿主病（aGVHD）风险分层及预后评估中的价值。
选取2020年1月至2022年3月在郑州大学第一附属医院接受allo-HSCT后发生aGVHD的70例儿童作为研究对象，其中轻度aGVHD（I-II级）50例，重度aGVHD（III-IV级）20例。选取同期在我院进行体检的30例健康儿童作为对照组。采用Luminex平台检测aGVHD发生期间REG3α、sST2和TNFR1的蛋白表达水平，三组间差异采用单因素方差分析。根据28天内aGVHD治疗结局，将患者分为预后良好组58例和预后不良组12例。采用ROC曲线分析REG3α、sST2和TNFR1在预测儿童aGVHD预后中的价值。
轻度aGVHD组和重度aGVHD组外周血REG3α、sST2和TNFR1水平均显著高于对照组（<0.05），且重度aGVHD组显著高于轻度aGVHD组（<0.05）。与预后良好组相比，预后不良组外周血REG3α、sST2和TNFR1水平显著更高（=9.27,3.33,2.97；<0.01）。ROC曲线分析显示，REG3α、sST2和TNFR1联合检测预测儿童aGVHD预后的曲线下面积（AUC）、敏感性和特异性均高于上述指标单独或两两检测。
REG3α、sST2和TNFR1的表达水平与aGVHD的严重程度相关。REG3α、sST2和TNFR1联合检测在预测儿童aGVHD预后方面具有较高的临床价值，有望为临床评估儿童aGVHD预后提供可靠参考。
