| 摘要: |
| ［摘要］ 目的 探讨急性淋巴细胞白血病（ALL）患儿血清信号素3A（SEMA3A）、信号素4D（SEMA4D）与危险度分层和预后的关系。方法 招募2019年3月至2023年3月宁夏医科大学总医院收治的128例ALL患儿，根据ALL危险度分层将患儿分为低危组（31例）、中危组（62例）和高危组（35例）。采用酶联免疫吸附试验法测定血清SEMA3A、SEMA4D水平。根据治疗结束后第12个月的预后情况将患儿分为预后不良组（26例）和预后良好组（102例），比较两组临床资料。采用Spearman秩相关分析SEMA3A、SEMA4D水平与ALL患儿危险度分层的相关性。采用多因素logistic回归分析ALL患儿预后不良的影响因素。结果 低危组、中危组、高危组SEMA3A水平依次下降，SEMA4D水平依次升高，差异有统计学意义（P<0.05）。Spearman秩相关分析结果显示，SEMA3A水平与ALL患儿危险度分层呈负相关（rs=-0.689，P<0.001），SEMA4D水平与ALL患儿危险度分层呈正相关（rs=0.452，P<0.001）。与预后良好组相比，预后不良组年龄更大，白细胞计数（WBC）、SEMA4D水平更高，SEMA3A水平更低，差异有统计学意义（P<0.05）。两组免疫学分型、危险度分层比较差异有统计学意义（P<0.05）。多因素logistic回归分析结果显示，较大的年龄、较高的WBC水平、较高的SEMA4D水平、免疫学分型为T-ALL、危险度分层为高危型是ALL患儿预后不良的独立危险因素（P<0.05），较高的SEMA3A水平是抑制ALL患儿预后不良发生的独立保护因素（P<0.05）。结论 ALL患儿血清SEMA3A、SEMA4D水平与危险度分层和预后密切相关，SEMA3A水平降低、SEMA4D水平升高可增加预后不良风险。 |
| 关键词: 儿童 急性淋巴细胞白血病 信号素3A 信号素4D 危险度分层 预后 |
| DOI：10.3969/j.issn.1674-3806.2025.09.12 |
| 分类号:R 733.71 |
| 基金项目:宁夏回族自治区科技支撑计划项目（编号：XT201968） |
|
| Relation of serum SEMA3A and SEMA4D with risk stratification and prognosis in pediatric patients with acute lymphoblastic leukemia |
|
TANG Changchao, ZUO Feng, BAI Hua, WEI Xueli
|
|
Department of Pediatrics, General Hospital of Ningxia Medical University, Yinchuan 750004, China
|
| Abstract: |
| ［Abstract］ Objective To explore the relation of serum semaphorin 3A(SEMA3A) and semaphorin 4D(SEMA4D) with risk stratification and prognosis in pediatric patients with acute lymphoblastic leukemia(ALL). Methods A total of 128 pediatric patients with ALL who were admitted to General Hospital of Ningxia Medical University from March 2019 to March 2023 were recruited. According to the risk stratification of ALL in these pediatric patients, they were divided into low-risk group(31 patients), medium-risk group(62 patients) and high-risk group(35 patients). The levels of serum SEMA3A and SEMA4D were measured using enzyme-linked immunosorbent assay(ELISA). According to the prognosis of the pediatric patients at 12 months after treatment, they were divided into poor prognosis group(26 patients) and good prognosis group(102 patients). The clinical data were compared between the two groups. Spearman rank correlation was used to analyze the correlation of the levels of SEMA3A and SEMA4D with the risk stratification of the ALL pediatric patients. Multivariate logistic regression was used to analyze the influencing factors of poor prognosis in the pediatric patients with ALL. Results The serum SEMA3A levels in the low-risk group, the medium-risk group and the high-risk group decreased successively, while their serum SEMA4D levels increased successively, with statistically significant differences(P<0.05). The results of Spearman rank correlation analysis showed that the SEMA3A level was negatively correlated with the risk stratification of ALL in the pediatric patients(rs=-0.689, P<0.001), while the SEMA4D level was positively correlated with the risk stratification of ALL in the pediatric patients(rs=0.452, P<0.001). Compared with the good prognosis group, the poor prognosis group was older, and had higher levels of white blood cell count(WBC) and SEMA4D, and lower levels of SEMA3A, with statistically significant differences(P<0.05). There were statistically differences in immunoclassification and risk stratification between the two gropus(P<0.05). The results of multivariate logistic regression analysis showed that older age, higher WBC level, higher SEMA4D level, immunoclassification of T-ALL and high-risk types in risk stratification were independent risk factors for poor prognosis in the pediatric patients with ALL(P<0.05), while higher SEMA3A level was an independent protective factor for poor prognosis in the pediatric patients with ALL(P<0.05). Conclusion The levels of serum SEMA3A and SEMA4D in pediatric patients with ALL are closely related to risk stratification and prognosis. A decrease in SEMA3A levels and an increase in SEMA4D levels can raise the risk of poor prognosis. |
| Key words: Children Acute lymphoblastic leukemia(ALL) Semaphorin 3A(SEMA3A) Semaphorin 4D(SEMA4D) Risk stratification Prognosis |
