非霍奇金淋巴瘤患者血清超氧化物歧化酶的表达及其临床意义

发布时间：2018-04-09 02:28

本文选题：非霍奇金淋巴瘤　切入点：超氧化物歧化酶　出处：《宁夏医科大学》2017年硕士论文

【摘要】：目的:探讨非霍奇金淋巴瘤(non-Hodgkin's lymphoma,NHL)患者血清超氧化物歧化酶(superoxide dismutase,SOD)的表达及其临床意义,分析血清SOD活性与患者的性别、年龄、分型、国际标准化预后指数(international prognostic index,IPI)评分、临床分期、血清乳酸脱氢酶(lactate dehydrogenase,LDH)等临床病理参数及化疗的关系,为NHL的临床诊疗提供参考。方法:1.收集2015年1月至2016年12月在甘肃省人民医院首诊的NHL患者114例,包括64例弥漫大B细胞淋巴瘤(diffuse large B-cell lymphoma,DLBCL),18例滤泡细胞淋巴瘤,4例间变大细胞淋巴瘤,2例套细胞淋巴瘤,18例NK-T细胞淋巴瘤,2例血管免疫母T细胞淋巴瘤,2例T细胞白血病/淋巴瘤,2例骨外浆细胞淋巴瘤,2例结外边缘区MALT粘膜相关淋巴瘤;120例健康对照组来自同期甘肃省人民医院体检中心的健康体检者。2.采用比色法(终点法)分别检测健康对照组、NHL组及CHOP方案化疗2周期后血清SOD活性,分析血清SOD活性的变化与NHL临床病理参数及化疗效果的关系。3.用SPSS19.0统计软件对检测结果进行分析。结果:1.基线均衡性比较:NHL组和健康对照组之间年龄、性别比例无统计学差异(P0.05)。2.NHL组与健康对照组血清SOD活性比较有统计学差异(P0.05)。3.NHL患者血清SOD活性与临床病理参数的关系:(1)NHL患者不同的年龄及性别血清SOD活性比较差异无统计学意义(P0.05)。(2)NHL患者不同的分型、IPI评分、临床分期血清SOD活性比较差异有统计学意义(P0.05)。(3)NHL患者LDH正常组与异常组血清SOD活性比较差异无统计学意义(P0.05)。4.用CHOP方案化疗2个疗程后完全缓解患者与治疗前患者血清SOD活性比较差异有统计学意义(P0.05)。5.NHL患者血清SOD活性与血清LDH呈负相关,r=-0.223,P0.05。6.根据ROC曲线分析,血清SOD曲线下面积为0.714,曲线下面积与零假设的实面积0.5比较差异有统计学意义。最佳分界点146.50U/ml是根据约登(Youden)指数测定的,灵敏度为75%,特异度为62.3%。结论:1.血清SOD活性降低可能参与了NHL的发生及病情演变过程。2.血清SOD活性可能对NHL的诊断有一定的参考价值。
[Abstract]:Objective: to investigate the expression and clinical significance of serum superoxide dismutase (SOD) in patients with non-Hodgkin 's lymphoma (non-Hodgkin 's lymphoma).The relationship between clinical pathological parameters and chemotherapy of serum lactate dehydrogenase and LDHs provides reference for clinical diagnosis and treatment of NHL.Method 1: 1.From January 2015 to December 2016, 114 patients with NHL were first diagnosed in Gansu Provincial people's Hospital.There are 64 cases of diffuse large B-cell lymphoma with diffused large B-cell lymphomatosis 18 cases of follicular cell lymphoma, 4 cases of anaplastic large cell lymphoma, 2 cases of anaplastic large cell lymphoma, 18 cases of NK-T cell lymphoma, 2 cases of vascular immunoblastic T-cell lymphoma and 2 cases of T cell white.Two patients with extraosseous plasmacytic lymphoma and two patients with MALT mucosa-associated lymphoma in the outer marginal region of the blood disease / lymphoma. 120 healthy controls were collected from the physical examination center of Gansu Provincial people's Hospital in the same period.The serum SOD activity was detected by colorimetric assay (endpoint method) in the healthy control group and after 2 cycles of chemotherapy with CHOP regimen. The relationship between the changes of serum SOD activity and the clinicopathological parameters of NHL and the effect of chemotherapy was analyzed.The test results were analyzed by SPSS19.0 software.The result is 1: 1.Baseline equilibrium comparison: age between the + NHL group and the healthy control group,There was no statistical difference in the sex ratio. 2. There was significant difference in serum SOD activity between the NHL group and the healthy control group. The relationship between the serum SOD activity and the clinicopathological parameters in the patients with NHL was not different from that in the control group. There was no significant difference in serum SOD activity between different ages and sexes in the patients with NHL.There were significant differences in IPI scores among different types of NHL patients.There was no significant difference in serum SOD activity between normal group and abnormal group in patients with LDH. There was no significant difference in serum SOD activity between normal group and abnormal group.There was a significant difference in serum SOD activity between patients with complete remission and patients before treatment after two courses of chemotherapy with CHOP regimen. There was a negative correlation between serum SOD activity and serum LDH in patients with complete remission and pre-treatment. There was a negative correlation between serum SOD activity and serum LDH.According to the analysis of ROC curve, the area under serum SOD curve was 0.714, and there was significant difference between the area under the curve and the real area of zero hypothesis.The optimal demarcation point 146.50U/ml was determined according to the Youden index with sensitivity of 75 and specificity of 62.3.Conclusion 1.The decrease of serum SOD activity may be involved in the pathogenesis and progression of NHL.The activity of serum SOD may have some reference value for the diagnosis of NHL.
【学位授予单位】：宁夏医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R733.1

【参考文献】