【摘要】：目的:探討B(tài)CL-2與PD-L1聯(lián)合檢測用于初治急性白血病患者預后評估的臨床價值。方法:選取本院血液科2013年1月至2016年9月收治的100例初治急性白血病患者,采用RT-PCR法檢測患者骨髓分離細胞中BCL-2及PD-L1的mRNA表達水平,并對患者的預后進行隨訪。根據(jù)隨訪結(jié)果將患者分為完全緩解組與未完全緩解組,統(tǒng)計并分析不同指標預測患者預后的約登指數(shù)。結(jié)果:與健康對照組相比,AL患者骨髓標本BCL-2、PD-L1陽性表達率均顯著升高(P0.01)。BCL-2單獨檢測預測患者預后顯示,曲線下面積(AUC)為0.725(P=0.006),判斷閾值為1.550,Sen和Spe分別為72.0%和84.0%。PD-L1單獨檢測預測患者預后顯示,AUC為0.740(P=0.004),判斷閾值為12.500,Sen和Spe分別為66.7%和73.1%。兩者聯(lián)合檢測顯示,并聯(lián)檢測診斷指數(shù)為77.90,高于串聯(lián)檢測54.75,亦高于2項指標單獨檢測的診斷指數(shù)。結(jié)論:BCL-2聯(lián)合PD-L1檢測應(yīng)用于初治急性白血病患者的預后評估,能夠提升檢測的特異度和敏感度,較2者單獨檢測有更高的診斷指數(shù)(約登指數(shù)),在臨床評估急性白血病患者預后中有一定臨床價值。
[Abstract]:Objective: to evaluate the clinical value of combined detection of BCL-2 and PD-L1 in evaluating the prognosis of patients with newly diagnosed acute leukemia. Methods: from January 2013 to September 2016, 100 patients with newly diagnosed acute leukemia were selected. The mRNA expression of BCL-2 and PD-L1 in bone marrow isolated cells was detected by RT-PCR method, and the prognosis of the patients was followed up. According to the follow-up results, the patients were divided into complete remission group and incomplete remission group, and the Jordan index of different indexes to predict the prognosis of patients was counted and analyzed. Results: compared with the healthy control group, the positive expression rate of BCL-2,PD-L1 in bone marrow samples of AL patients was significantly higher (P 0.01). The prognosis of AL patients predicted by BCL-2 alone was 0.725 (P 鈮，

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