Application value of serum and cerebrospinal fluid laboratory indexes in the diagnosis and treatment of pediatric patients with retinoblastoma

Abstract

Objective To analyze the experimental index changes of serum and cerebrospinal fluid (CSF) before and after chemotherapy in children with retinoblastoma (RB), to explore the clinical value of these parameters in the diagnosis and treatment of RB. Methods 28 children with RB in our hospital from May 2010 to April 2016 were collected, and divided into CNS metastasis group (13 cases) and external phase group (15 cases) according to RB stage. The changes of serum neuronspecific enolase (NSE), serum lactate dehydrogenase (LDH) and cerebrospinal fluid NSE, LDH, protein quantitation, and WBC at different time points before and after chemotherapy were measured in the two groups. Results Among 13 cases in CNS metastasis group, there were 10 cases whose cerebrospinal fluid tumor cytology inspect for RB cells were positive. In the two groups, the level of serum NSE at the third and sixth cycle of chemotherapy were significantly lower than that before chemotherapy (P<0.05); the level of serum NSE in CNS metastasis group was significantly higher than that in external phase group at each time point (P<0.05). The level of serum LDH before chemotherapy in CNS metastasis group was significantly higher than that in external phase group, that at the third and sixth cycle of chemotherapy were significantly lower than that before chemotherapy (P<0.05). The NSE content in CSF in CNS metastasis group at each time point was significantly higher than that in external phase group (P<0.05). The protein quantitation in CSF in CNS metastasis group at each time point was significantly higher than that in external phase group (P<0.05). CSF WBC in CNS metastasis group at each time point was significantly higher than that in external phase group (P<0.05), that at the third cycle of chemotherapy was slightly higher than that before chemotherapy, that at the sixth cycle of chemotherapy was significantly lower than that before chemotherapy (P<0.05); WBC at the third and sixth cycle of chemotherapy were significantly lower than that before chemotherapy in external phase group (P<0.05). Conclusions The detection of serum and CSF NSE levels can be used to monitor the condition change before and after chemotherapy in patients with CNS metastasis and external phase RB. CSF protein quantitation and WBC can assist the diagnosis of RB metastasis to CNS. Determination of serum LDH level can not be used for CNS metastasis and the differential diagnosis and condition monitoring in children with RB. Key words: Neuronspecific enolase; Lactate dehydrogenase; Cerebrospinal fluid; Protein quantification; White blood count