Objective To investigate the clinical significance of serum NSE/NSE detection before and after autologous peripheral blood stem cell transplantation (ABSCT) in children with stage Ⅳ neuroblastoma. Methods Eighteen children with stage Ⅳ neuroblastoma treated in our pediatric department from October 2006 to August 2008 were enrolled in this study. The levels of serum NSE/LDH before and after ABSCT were analyzed to explore the relationship between serum NSE/LDH and disease, and detect the correlation of NSE and LDH as well. Results (1) The positive rate of serum NSE in patients with Ⅳ neuroblastoma was increased (16/18 cases) , and the levels of NSE and LDH were significantly higher before treatment ( P ＜ 0.01) ; ( 2) There were significant differences of serum NSE and LDH levels between patients with complete remission ( CR) and partial remission ( PR) after comprehensive treatment (P ＜ 0. 05 ) ; ( 3 ) There were no differences of serum NSE/LDH levels before and after treatment in progressive cases ( P ＞ 0.05 ) ; (4) Eight CR cases achieved complete remission 1 month after ABSCT, and the level of NSE had no change compared with that before transplantation (P ＞ 0.05 ) , while LDH had significantly changed (P ＜ 0. 05 ) ; three PR cases achieved complete remission, and 3 got partial remission. The levels of NSE/LDH decreased after transplantation (P ＜0.05); one progressive case died and was not detected, while the other 3 cases relieved slightly after transplantation. The levels of NSE/LDH had no change (P ＞0. 05). Both NSE and LDH were positively correlated in the course of the disease (r = 0. 55, P ＜ 0.01). Conclusions The levels of serum NSE/LDH may reflect the tumor load in children with stage IV neuroblastoma, which had close relationship with tumor relapse and therapeutic effect, indicating that it could be used as an index for monitor.%目的 探讨血清神经元特异性烯醇化酶( NSE)和乳酸脱氢酶(LDH)水平在Ⅳ期神经母细胞瘤患儿治疗前及自体外周血造血干细胞移植(APBSCT)治疗前后的变化及其临床意义.方法 选择2006年10月-2008年8月我科收治的18例Ⅳ期神经母细胞瘤患儿,对治疗前、APBSCT治疗前后血清NSE与LDH水平进行比较,分析血清NSE、LDH水平与病情变化的关系,探讨血清NSE与LDH水平的相关性.结果 (1)Ⅳ期神经母细胞瘤患儿治疗前血清NSE阳性率高(16/18例),NSE、LDH水平均明显高于治疗有效时(P＜0.01)；(2)经过化疗、手术切除及放疗等综合治疗,完全缓解期患儿血清NSE、LDH水平与部分缓解期患儿相比差异均有显著性(P＜0.05)；(3)肿瘤进展期患儿血清NSE、LDH水平与治疗前相比差异无显著性(P＞0.05)；(4) APBSCT治疗结束后1个月NSE、LDH水平,移植前完全缓解期8例移植后仍为完全缓解,与移植前相比NSE水平无明显变化(P＞0.05),但LDH水平显著下降(P＜0.05)；移植前处于部分缓解期的6例中,3例移植后获得完全缓解,3例获得部分缓解,与移植前相比,NSE、LDH水平均有所下降(P＜0.05)；移植前处于进展期的4例中,1例死亡未测,3例造血重建后病情稍缓解,NSE、LDH水平与移植前相比差异无显著性(P＞0.05).NSE与LDH水平在疾病病程中呈正相关(r=0.55,P＜0.01).结论 血清NSE、LDH水平可反映Ⅳ期神经母细胞瘤患儿肿瘤负荷,与肿瘤疗效和复发有关,提示其可作为监测神经母细胞瘤疗效的辅助性指标.
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