中国循证儿科杂志2013，Vol.8Issue(2)：122-125,4.DOI:10.3969/j.issn.1673-5501.2013.02.008
半胱氨酸蛋白酶8相关蛋白2及微小残留病灶的联合检测在儿童急性淋巴细胞白血病中的预后意义
Prognostic significance of CASP8AP2 and joint detection of minimal residual disease in pediatric acute lymphoblastic leukemia
摘要
Abstract
Objective To investigate CASP8AP2 expression in childhood acute lymphoblastic leukemia ( ALL ), its associations with clinical characteristics, and its prognostic significance for disease relapse. Methods Clinical data of patients with newly diagnosed childhood ALL were enrolled in Beijing Children's Hospital from April 2008 to August 2009. Using real-time quantitative polymerase chain reaction ( RQ-PCR ), CASP8AP2 was quantitatively detected in 81 ALL patients, ABL was detected simultaneously and used as an internal control. The average Ct value of samples obtained from five pediatric ALL patients with long-term complete continuous remission ( CCR > 5 years ) was used as a calibrator. The expression levels of CASP8AP2 were calculated by the 2 - △△Ct method and presented as fold changes compared with that of the five CCR patients. Results Eighty-one children diagnosed with ALL were included in the study. The ratio of males to females was 1.6. ①The ROC curve of CASP8AP2 was made to predict the relapse of pediatric ALL, and the area under the curve ( AUC ) was 0. 851(P<0.001). ② The expression of CASP8AP2 in the unfavorable prognosis group was significantly lower than that in the favorable prognosis group, ( 0.45 ±0. 31 ) vs ( 0.77 ± 0. 35 ) ,P = 0. 0021. ③ Using a cutoff value of 0. 4760, CASP8AP2 may be divided into high- and low-expression groups. Significantly poorer event-free survival ( EFS ) ( P < 0. 001 ) and overall survival ( OS ) ( P < 0. 001 ) were found in the low-expression group. ④ Using the expressions of CASP8AP2 and minimal residual disease ( MRD ) as bases, samples were divided into three risk groups. Differences between groups were statistically significant and indicated the capacity to predict the relapse of disease ( AUC =0. 917, P < 0. 001 ). Conclusions The expression of CASP8AP2 could be an independent prognostic factor for pediatric ALL. Joint detection of CASP8AP2 and MRD could help predict outcomes more precisely and has the potenticals to be sued as an effective means in determining prognosis, monitoring the risk of recurrence, and guiding the treatment.关键词
急性淋巴细胞白血病/半胱氨酸蛋白酶8相关蛋白2/微小残留病灶/联合检测/预后/儿童Key words
Acute lymphoblastic leukemia/ Caspase 8 associated protein 2/ Minimal residual disease/ Joint detection/ Prognosis/ Children引用本文复制引用
梅妍妍,高超,崔蕾,李伟京,赵晓曦,吴敏媛,李志刚..半胱氨酸蛋白酶8相关蛋白2及微小残留病灶的联合检测在儿童急性淋巴细胞白血病中的预后意义[J].中国循证儿科杂志,2013,8(2):122-125,4.基金项目
国家科技重大专项课题:2011ZX09302-007-01 （）
国家科技支撑计划课题:2007BAI04B03 （）
