血清轴突导向因子4D、纤维蛋白原/白蛋白比值与急性髓系白血病患者预后的相关性

doi:10.3969/j.issn.1673-8640.2025.08.008

摘要/Abstract

摘要：

目的探讨急性髓系白血病（AML）患者血清轴突导向因子4D（Sema4D）、纤维蛋白原/白蛋白比值（FAR）与疾病预后的相关性。方法选取2018年5月—2020年7月秦皇岛市第一医院AML患者120例（AML组），根据染色体核型分为高危组、中危组、低危组，根据患者3年生存情况分为生存组和死亡组。另选取同期秦皇岛市第一医院缺铁性贫血（IDA）患者80例（IDA组）和体检健康者80名（健康对照组）。比较各组血清Sema4D水平和FAR差异。采用Spearman相关分析评价血清Sema4D、FAR与AML患者预后的相关性；采用受试者工作特征（ROC）曲线评价血清Sema4D、FAR预测AML患者预后的效能。采用Kaplan-Meier生存曲线分析AML患者的生存情况。结果 AML组、IDA组、健康对照组血清Sema4D水平、FAR均依次降低（P<0.05）。高危组、中危组、低危组血清Sema4D水平和FAR依次降低（P<0.05）。AML患者血清Sema4D、FAR与疾病危险程度均呈正相关（r值分别为0.452、0.577，P<0.001）。生存组血清Sema4D水平、FAR低于死亡组（P<0.05）。血清Sema4D、FAR联合检测预测AML患者预后的AUC（0.824）高于2项指标单项检测的AUC（0.649、0.724）（P<0.05）。血清Sema4D高表达、FAR较高的AML患者3年生存率低于Sema4D低表达、FAR较低的AML患者（P<0.05）。结论 AML患者Sema4D水平和FAR升高，低表达Sema4D、低FAR患者3年生存率较高。2项指标联合检测预测AML患者预后的效能较高。

关键词: 轴突导向因子4D, 纤维蛋白原/白蛋白比值, 急性髓系白血病

Abstract:

Objective To investigate the correlation between serum semaphorin 4D（Sema4D），fibrinogen-to-albumin ratio（FAR） and prognosis in patients with acute myeloid leukemia（AML）. Methods Totally，120 AML patients from Qinhuangdao First Hospital from May 2018 to July 2020 were enrolled as AML group. They were classified into high-risk group，intermediate-risk group and low-risk group according to karyotypes，and into survival group and death group according to 3-year survival status. Another 80 patients with iron deficiency anemia（IDA） and 80 healthy subjects were enrolled as IDA group and healthy control group，respectively. The differences in serum Sema4D levels and FAR were compared among the groups. Spearman correlation analysis was used to evaluate the correlation of serum Sema4D，FAR and the prognosis of AML patients. Receiver operating characteristic（ROC） curve was used to evaluate the efficacy of serum Sema4D and FAR in predicting the prognosis of AML patients. The survival status of AML patients was evaluated by Kaplan-Meier survival curve. Results The levels of serum Sema4D and FAR in AML group，IDA group and healthy control group were decreased successively（P<0.05）. The levels of serum Sema4D and FAR in high-risk group，intermediate-risk group and low-risk group were decreased successively（P<0.05）. Serum Sema4D and FAR in AML patients were positively correlated with the risk degree（r=0.452 and 0.577，P<0.001）. The serum Sema4D level and FAR in survival group were lower than those in death group（P<0.05）. The combined determination of serum Sema4D and FAR had a higher area under curve（AUC）（0.824） in predicting the prognosis of AML patients than single determinations（0.649 and 0.724）（P<0.05）. The 3-year survival rate of patients with high expression of serum Sema4D and high FAR was lower than that of patients with low expression of serum Sema4D and low FAR（P<0.05）. Conclusions The levels of Sema4D and FAR in AML patients are increased. Patients with low expression of Sema4D and low FAR have a higher 3-year survival rate. The combined determination of serum Sema4D and FAR has a higher efficacy in predicting the prognosis of AML patients.

Key words: Semaphorin 4D, Fibrinogen-to-albumin ratio, Acute myeloid leukemia

中图分类号:

R446.1

郭媛媛, 宋辉, 张琳. 血清轴突导向因子4D、纤维蛋白原/白蛋白比值与急性髓系白血病患者预后的相关性[J]. 检验医学, 2025, 40(8): 769-774.

GUO Yuanyuan, SONG Hui, ZHANG Lin. Correlation between serum Sema4D，fibrinogen-to-albumin ratio and prognosis in patients with acute myeloid leukemia[J]. Laboratory Medicine, 2025, 40(8): 769-774.

图/表 9

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组别	例数	年龄/岁	性别		Sema4D/（ng·mL^-1）	FAR
组别	例数	年龄/岁	男/例	女/例	Sema4D/（ng·mL^-1）	FAR
AML组	120	55.24±13.25	63	57	15.33±1.39^*#	0.082±0.014^*#
IDA组	80	53.73±13.05	43	37	7.91±0.82^*	0.047±0.013^*
健康对照组	80	53.19±12.76	45	35	5.25±0.52	0.033±0.012
统计值		0.672	0.273		2 517.480	355.468
P值		0.512	0.872		< 0.001	<0.001

组别	例数	年龄/岁	性别		Sema4D/（ng·mL^-1）	FAR
组别	例数	年龄/岁	男/例	女/例	Sema4D/（ng·mL^-1）	FAR
AML组	120	55.24±13.25	63	57	15.33±1.39^*#	0.082±0.014^*#
IDA组	80	53.73±13.05	43	37	7.91±0.82^*	0.047±0.013^*
健康对照组	80	53.19±12.76	45	35	5.25±0.52	0.033±0.012
统计值		0.672	0.273		2 517.480	355.468
P值		0.512	0.872		< 0.001	<0.001

组别	例数	Sema4D/（ng·mL^-1）	FAR
低危组	36	12.25±1.43	0.065±0.012
中危组	44	15.59±0.96^*	0.084±0.011^*
高危组	40	17.83±1.35^*#	0.094±0.013^*#
F值		190.792	56.727
P值		<0.001	<0.001

组别	例数	Sema4D/（ng·mL^-1）	FAR
低危组	36	12.25±1.43	0.065±0.012
中危组	44	15.59±0.96^*	0.084±0.011^*
高危组	40	17.83±1.35^*#	0.094±0.013^*#
F值		190.792	56.727
P值		<0.001	<0.001

组别	例数/例	Sema4D/（ng·mL^-1）	FAR
生存组	78	15.06±1.29	0.075±0.021
死亡组	42	15.84±1.48	0.094±0.018
t值		3.026	4.962
P值		0.003	<0.001