Bim和ULBP2的水平对肾母细胞瘤术后患儿复发及预后的影响

目的探讨并分析肾母细胞瘤术后患儿血清中Bim和ULBP2的水平变化,并分析其对患儿术后复发及预后的影响。方法选择行单侧肾母细胞瘤切除术患儿60例,根据不同分期分为2组,分别为中期组(Ⅱ~Ⅲ期,43例)和晚期组(Ⅳ~Ⅴ期,17例),人ELISA试剂盒检测各组患者血清中Bim和ULBP2的含量并进行比较,进一步分析其对患者复发及预后情况的影响。结果与中期组瘤组织相比,晚期组瘤组织中BIM相对表达量均显著降低,ULBP2相对表达量均显著增加(P<0.05);与瘤旁组织相比,两组瘤组织中BIM相对表达量均显著降低,ULBP2相对表达量均显著增加(P均<0.05)。与术前1 d和术后1 h相比,术后1 w两组患儿血清中Bim含量均显著上升,ULBP2含量均显著下降(P均<0.05),而两组患儿术前1 d和术后1 h相比,两指标变化均不具统计学意义(P均>0.05)。与中期组相比,晚期组术前1 d、术后1 h以及术后1 w,患儿血清中Bim含量均显著上升,ULBP2含量均显著下降(P均<0.05)。与中期组相比,晚期组术后复发、肺转移以及死亡等不良预后状况的总发生率显著上升(P<0.05)。肾母细胞瘤患儿预后状况与其根治性瘤肾切除术后血清中Bim的含量呈显著负相关,与血清中ULBP2的含量呈显著正相关(P均<0.01)。结论肾母细胞瘤术后可通过患儿血清中Bim和ULBP2的水平变化对其复发及预后进行评价,其预后状况与根治性瘤肾切除术后血清中Bim的含量呈显著负相关,与血清中ULBP2的含量呈显著正相关。

The Influence of Bim and ULBP2 Levels on the Recurrence and Prognosis of Postoperative Wilms Tumor in Children

Objective To investigate and analyze the changes of serum Bim and ULBP2 levels in children after nephroblastoma surgery,and analyze their effects on the recurrence and prognosis of children after surgery.Methods 60 children undergoing unilateral Wilms tumor resection were selected and divided into 2 groups according to different stages,they were the mid-term group(stageⅡ~Ⅲ,39 cases)and the late group(stageⅣ~Ⅴ,25 cases).Human ELISA kits were used to detect the levels of Bim and ULBP2 in the serum of each group of patients and compared for further analysis its impact on patients'relapse and prognosis.Results Compared with the middle-stage tumor tissue,the relative expression of BIM in the advanced tumor tissue was significantly reduced,and the relative expression of ULBP2 was significantly increased(P<0.05);Compared with the adjacent tumor tissues,the relative expression of BIM in both groups of tumor tissues was significantly reduced,and the relative expression of ULBP2 was significantly increased(P<0.05).Compared with 1 d before surgery and 1 h after surgery,the serum Bim content of the 2 groups of children increased significantly and the ULBP2 content of the 2 groups decreased significantly(all P<0.05).Compared with the first 1 day and 1 hour after the operation,the changes of the 2 indexes were not statistically significant(both P>0.05).Compared with the mid-term group,in the late-stage group,the serum Bim content increased significantly and the ULBP2 content decreased significantly(all P<0.05)before operation,1 hour after operation,and 1 week after operation.Compared with the mid-term group,the overall incidence of adverse prognostic conditions such as recurrence,lung metastasis,and death increased significantly in the late-stage group(P<0.05).The prognosis of children with nephroblastoma was significantly negatively correlated with serum Bim content after radical nephrectomy,and significantly positively correlated with serum ULBP2 content(all P<0.05).Conclusion Wilms tumors can be evaluated for their recurrence and prognosis by changing the levels ofBim and ULBP2 in children's serum after surgery.The prognosis status is significantly negatively correlated with serum Bim content after radical nephrectomy,and is significantly positively correlated with serum ULBP2 content.