【摘要】 目的 分析急性髓系白血病（AML）患者血清可溶性晚期糖基化终末产物受体（sRAGE）、足糖萼蛋白（PODXL）的表达与AML患者临床病理特征和预后的关系。方法 纳入2018年5月至2022年12月在郑州大学第五附属医院确诊并接受化疗的AML患者90例（AML组）,同期纳入健康体检者68例（健康组）。ELISA法检测血清sRAGE、PODXL水平；采用ROC曲线评估血清sRAGE、PODXL诊断AML的价值；采用Kaplan-Meier生存曲线评估生存结果；采用Cox回归分析影响AML患者预后的危险因素。结果 AML组患者血清sRAGE水平明显低于健康组，血清PODXL水平明显高于健康组（P<0.05）。血清sRAGE、PODXL表达水平与白细胞计数（WBC）有关（P<0.05）。血清sRAGE、PODXL二者联合诊断AML的AUC为0.907,高于单项检测(Z_{二者联合-sRAGE}=3.415、Z_{二者联合-PODXL}=3.007,P<0.05)。sRAGE高表达患者2年生存率显著高于sRAGE低表达（Log-Rank χ²=12.450,P<0.001）;PODXL高表达患者2年生存率显著低于PODXL低表达（Log-Rank χ²=14.716,P<0.001）。WBC≥10×10⁹/L以及sRAGE低表达、PODXL高表达是影响AML患者2年预后的危险因素（HR=1.794、0.799、2.179,95%CI=1.022～3.149、0.661～0.966、1.220～3.892,P<0.05）。结论 AML患者血清sRAGE低表达、PODXL高表达，二者联合检测对AML的诊断和预后具有较高的价值。更多还原

【Abstract】 Objective To analyze the expression of serum soluble receptor for advanced glycation endproducts（sRAGE） and podocalyxin（PODXL）,and their relationships with the clinicopathological features and prognosis in patients with acute myeloid leukemia（AML）.Methods From May 2018 to December 2022,90 AML patients diagnosed and receiving chemotherapy in our hospital（AML group） were included, and 68 healthy individuals（healthy group） were included.ELISA method was performed to detect serum sRAGE and PODXL.ROC curve was used to evaluate the diagnostic value of serum sRAGE and PODXL in AML.Kaplan-Meier survival curve was performed to evaluate survival outcomes.Cox regression analysis was performed to explore the risk factors affecting the prognosis of AML patients.Results The AML group had significantly lower serum sRAGE and significantly higher serum PODXL than healthy group（P<0.05）.Serum sRAGE and PODXL were related to white blood cell count（WBC）（P<0.05）.The AUC for the joint diagnosis of AML by serum sRAGE and PODXL was 0.907,which was higher than that of single detection(Z_joint-sRAGE=3.415,Z_joint-PODXL=3.007,P<0.05).Patients with high sRAGE expression had a significantly higher 2-year survival rate than those with low sRAGE expression（Log-Rank χ²=12.450,P<0.001）;patients with high PODXL expression had a significantly lower 2-year survival rate than those with low PODXL expression（Log-Rank χ²=14.716,P<0.001）.WBC≥10×10⁹/L,low expression of sRAGE and high expression of PODXL were risk factors affecting the 2-year prognosis of AML patients（HR=1.794,0.799,2.179,95%CI=1.022～3.149,0.661～0.966,1.220～3.892,P<0.05）.Conclusion Serum sRAGE is low and PODXL is high in AML patients.The combined assessment of these two biomarkers holds promise for the diagnosis and prognosis of AML.更多还原