血清唾液酸水平在淋巴瘤患者中的变化及意义

Changes and Significance of Serum Sialic Acid Levels in Patients with Lymphoma

摘要: 目的：探讨血清唾液酸(SA)水平在初治淋巴瘤患者中的变化及意义。方法：收集236例初治淋巴瘤患者临床特征参数，回顾性分析血清SA水平与淋巴瘤患者临床特征参数相关性及其对疗效和预后的影响。结果：与健康者比较，淋巴瘤患者血清SA水平显著升高(P < 0.05)。与治疗前比较，患者缓解后血清SA水平显著降低(P < 0.05)。与低SA组比较，高SA组患者具有侵袭性更强、分期更晚、危险度分层更高、更易贫血的特点，并且具有更高的LDH和ki-67水平，差异具有统计学意义(P < 0.05)。单因素分析结果示SA > 605 mg/L、年龄 > 60岁、贫血、LDH > 250 U/L、ki67 > 45%、高危危险度分层的淋巴瘤患者PFS显著缩短(P < 0.05)，SA > 605 mg/L、年龄 > 60岁、贫血、LDH > 250 U/L、ki67 > 45%、高危危险度分层、侵袭性淋巴瘤患者OS显著缩短(P < 0.05)。多因素分析显示年龄是影响淋巴瘤患者PFS和OS的独立预后因素(P < 0.05)。高SA组患者总缓解率(ORR)、疾病控制率(DCR)显著低于低SA组患者(P < 0.05)。结论：与健康人比较，初治淋巴瘤患者血清SA水平明显升高；血清SA水平升高有助于预测淋巴瘤患者预后不良，以及判断疾病分期、疗效和预后。

Abstract: Objective: To investigate the changes and significance of serum sialic acid (SA) levels in patients with new-diagnosed lymphoma. Methods: The clinical parameters of 236 patients with new-diagnosed lymphoma were collected, and the correlation between serum SA level and clinical parameters of lymphoma patients and its influence on efficacy and prognosis were retrospectively analyzed. Results: Compared with healthy subjects, serum SA levels were significantly increased in lymphoma patients (P < 0.05). Serum SA levels were significantly lower in patients after remission compared with those before treatment (P < 0.05). Compared with the low SA group, patients in the high SA group were characterized by more aggressive, more advanced stage, risk stratification, and more susceptibility to anemia, and had higher LDH and ki-67 levels, and the differences were statistically significant (P < 0.05). Univariate analysis showed that PFS was significantly shorter in lymphoma patients with SA > 605 mg/L, age > 60 years, anemia, LDH > 250 U/L, ki67 > 45%, and risk stratification (P < 0.05), and OS was significantly shorter in lymphoma patients with SA > 605 mg/L, age > 60 years, anemia, LDH > 250 U/L, ki67 > 45%, risk stratification, and invasive lymphoma (P < 0.05). Multivariate analysis showed that age was an independent prognostic factor for PFS and OS in lymphoma patients (P < 0.05). The overall response rate (ORR) and disease control rate (DCR) of patients in the high SA group were significantly lower than those of patients in the low SA group (P < 0.05). Conclusion: Compared with healthy individuals, serum SA levels were significantly increased in patients with primary lymphoma; elevated serum SA levels indicated a poor prognosis in patients with lymphoma and helped to determine disease stage, efficacy and prognosis.