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Title: [Correlation Analysis between Serum Fibronectin 3 Levels and Early Severe Bleeding in Patients with Newly Diagnosed Acute Promyelocytic Leukemia].
Author: Zhao HB, Qiao JJ, He XH.
Journal: Zhongguo Shi Yan Xue Ye Xue Za Zhi; 2024 Aug; 32(4):1058-1062. PubMed ID: 39192398.
Abstract:
OBJECTIVE: To analyze the correlation between serum fibronectin 3 (Ficolin-3) levels and early severe bleeding in newly diagnosed acute promyelocytic leukemia (APL) patients. METHODS: A total of 125 patients with newly diagnosed APL admitted to Shanxi Bethune Hospital from January 2020 to August 2023 were selected. All patients were given all-trans retinoic acid+arsenic for induction therapy. The severe bleeding events within 30 days of induction therapy (assessed by WHO bleeding score, grade 0, grade 1 and grade 2 were no bleeding or mild bleeding, grade 3 and grade 4 were severe or fatal bleeding) were used as observation endpoints. The serum Ficolin-3 levels was dected by ELISA method, baseline data and other laboratory indicators were counted, and the correlation between serum Ficolin-3 levels and early severe bleeding in newly diagnosed APL patients was analyzed. RESULTS: 23 out of 125 APL patients experienced early severe bleeding during induction therapy, including 13 cases of grade 3 bleeding and 10 cases of grade 4 bleeding. There were 102 cases of non-serious bleeding, including 30 cases of grade 0, 24 cases of grade 1 bleeding, and 48 cases of grade 2 bleeding. The proportion of serum promyelocytes, white blood cell count, and D-D level in the severe bleeding group were significantly higher than those in the non severe bleeding group (P < 0.05), while the levels of PLT and FIB were significantly lower than those in the non-serious bleeding group (P < 0.05). The serum Ficolin-3 levels in the severe bleeding group were significantly lower than those in the non severe bleeding group before treatment, days of treatment, 14 days of treatment, and 30 days of treatment (P < 0.05). Confirmed by point two column correlation, serum Ficolin-3 levels were negatively correlated with early severe bleeding in newly diagnosed APL patients before treatment, 7 days, 14 days, and 30 days after treatment (r values were -0.485, -0.397, -0.304, and -0.183, respectively). The receiver operating characteristic curve (ROC) graph of the subjects was drawn, and the results showed that the area under the curve (AUC) of serum Ficolin-3 levels before treatment and at 7 and 14 days after treatment for predicting early severe bleeding in newly diagnosed APL patients was greater than 0.7, all of which had certain predictive efficacy, and the serum Ficolin-3 level before treatment had the best predictive efficacy. CONCLUSION: The serum Ficolin-3 levels in newly diagnosed APL patients are associated with early severe bleeding, and the serum Ficolin-3 levels before treatment have a significant advantage in predicting early severe bleeding in newly diagnosed APL patients. 题目: 初诊急性早幼粒细胞白血病患者血清纤维胶凝蛋白3水平与早期严重出血的相关性分析. 目的: 分析初诊急性早幼粒细胞白血病（APL）患者血清纤维胶凝蛋白3（Ficolin-3）水平与早期严重出血的相关性。. 方法: 选择2020年1月-2023年8月期间山西白求恩医院收治的125例初诊APL患者，所有患者均给予全反式维甲酸+砷剂进行诱导治疗，以诱导治疗30 d内严重出血事件（以WHO出血评分进行评估，0级、1级、2级为无出血或轻度出血，3级、4级为严重或致命性出血）作为观察终点，采用酶联免疫吸附法（ELISA）检测患者血清Ficolin-3水平，统计患者基线资料及其他实验室指标，分析血清Ficolin-3水平与初诊APL患者早期严重出血的相关性。. 结果: 125例APL患者在诱导治疗期间发生早期严重出血的患者23例，其中3级出血13例，4级出血10例；非严重出血共102例，其中0级30例，1级出血24例，2级出血48例。严重出血组的血清早幼粒细胞比例、白细胞计数、D-D水平均明显高于非严重出血组（P < 0.05），PLT、FIB水平均明显低于非严重出血组（P < 0.05）。严重出血组治疗前、治疗后7、14和30 d的血清Ficolin-3水平均明显低于非严重出血组（P < 0.05）；经点二列相关性证实，治疗前和治疗后7、14、30 d血清Ficolin-3水平与初诊APL患者早期严重出血呈负相关（r 值依次为-0.485、-0.397、-0.304、-0.183）。绘制受试者工作特征曲线（ROC）图，结果显示，治疗前、治疗后7和14 d血清Ficolin-3水平对初诊APL患者早期严重出血预测的曲线下面积（AUC）均＞0.7，均有一定预测效能，且以治疗前血清Ficolin-3水平预测效能最佳。. 结论: 初诊APL患者血清Ficolin-3水平与早期严重出血有关，且治疗前血清Ficolin-3水平在预测初诊APL患者早期严重出血时有显著优势。.

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