白血病患儿癌症相关认知障碍前哨因子及其评估工具研究进展

Research advances in sentinel factors for cancer-related cognitive impairment and related assessment tools in children with leukemia

摘要

癌症相关认知障碍是白血病患儿常见且严重的并发症，影响患儿远期生存质量，并对其学业、生活及社交产生不良影响。通过文献综述，本文总结出癌症相关认知障碍前哨因子包括失眠、焦虑、抑郁、大剂量甲氨蝶呤暴露、脑脊液中溶血磷脂酰胆碱水平降低，鞘磷脂浓度升高、MTHFR1298基因型以及肿瘤坏死因子α、白介素6、白介素8升高。目前有关前哨因子的评估工具缺乏敏感性及特异性，建议后续开展大样本、多中心研究验证以上指标对白血病患儿癌症相关认知障碍的精准预测性，实现早期干预，以提高患儿远期生存质量。

Abstract

Cancer-related cognitive impairment is a common and serious complication in children with leukemia，which affects the quality of long-term survival and has adverse impact on their schooling，life，and socialization. Through a literature review，this article summarizes the sentinel factors for cancer-related cognitive impairment，including insomnia，anxiety，depression，high-dose methotrexate exposure，decreased lysophosphatidylcholine levels and elevated sphingomyelin concentrations in cerebrospinal fluid，MTHFR1298 genotype，and increases in inflammatory factors（TNF-α，IL-6，and IL-8）. The existing assessment tools for sentinel factors lack sensitivity and specificity，and subsequent large-sample multicenter studies should be conducted to validate the accuracy of the above indicators in predicting cancer-related cognitive impairment in children with leukemia，so as to achieve early intervention and improve the quality of long-term survival.

关键词

白血病 / 认知障碍 / 癌症 / 儿童

Key words

leukemia / cognitive impairment / cancer / children

基金资助

国家自然科学基金面上资助项目(72474040)