肿瘤相关性贫血儿童促红细胞生成素和肿瘤坏死因子α相关性研究

Correlation between Erythropoietin and Tumor Necrosis Factor Alpha in Children with Malignant Tumor Anemia

摘要: 目的：本文旨在检测肿瘤相关性贫血(Cancer-Related Anemia, CRA)儿童促红细胞生成素(EPO)和肿瘤坏死因子(TNF)-α水平，以探讨两者及分别与血红蛋白(Hemoglobin, Hb)水平的相关性。方法：对恶性肿瘤(包括肿瘤贫血42例和肿瘤非贫血33例)及非肿瘤性贫血18例、健康查体儿童15组例采用化学发光法测定血清中EPO、TNF-α水平，分析EPO与Hb、TNF-α与Hb及EPO与TNF-α的相关性。结果：肿瘤贫血患儿血清EPO、TNF-α水平明显高于肿瘤非贫血及健康患儿(p < 0.05)，肿瘤贫血患儿血清EPO与非肿瘤贫血比较差异无统计学意义(p > 0.05)；肿瘤贫血组患儿血清EPO、TNF-α与Hb均呈负相关关系(r = −0.41、−0.48，p均<0.05)，TNF-α与EPO及O/P相关性均无统计学意义(r = −0.16、−0.24，p均>0.05)。结论：儿童CRA中内源性EPO对贫血的反馈性增生是充分的，TNF-α作为负向调控因子参与CRA，但其引起贫血的机制与抑制EPO产生无关。

Abstract: Objective: This article aims to investigate the levels of erythropoietin (EPO) and tumor necrosis fac-tor (TNF)-α in children with tumor-associated anemia (CRA), and to investigate the relationship be-tween them and their correlation with hemoglobin (Hb) levels. Method: Patients (n = 108) with CRA or non-neoplastic hematological anemia and healthy control are selected. The chemiluminescence method was used to detect the serum level of EPO and TNF-α. The correlation between EPO and Hb, TNF-α and Hb, EPO and TNF-α is analyzed. Results: The levels of serum EPO and TNF-α in children with CRA were significantly higher than those in patients with non-anemia and healthy control (p < 0.05). But there was no significant difference compared with non-neoplastic hematological children (p > 0.05). Furthermore, the expected inverse linear relation between serum EPO and Hb levels was found in CRA, and so did the relation between serum TNF-α and Hb levels (r = −0.41, −0.48, p < 0.05). But there was no correlation between TNF-α and EPO or O/P (r = −0.16, −0.24, p > 0.05). Conclusion: The feedback hyperplasia of endogenous EPO to anemia in children’s CRA is sufficient. TNF-α is involved in CRA as a negative regulator, but its mechanism of causing anemia is not related to the inhibition of EPO production.