多发性骨髓瘤患者血清中VEGF水平的临床意义  

Clinical Significance of Serum Vascular Endothelial Growth Factor in Patients with Multiple Myeloma

作　　者：李欣[1] 魏秀珍[2] 刘晋玮[1] 耿传营[1] 陈文明[1] 

机构地区：[1]首都医科大学附属北京朝阳医院血液科,北京100020 [2]首都医科大学附属北京朝阳医院检验科,北京100020

出　　处：《中国实验血液学杂志》2014年第1期108-111,共4页Journal of Experimental Hematology

基　　金：国家自然科学基金(81172252);首都临床特色应用研究专项资助课题(Z131107002213146)

摘　　要：本研究探讨血管内皮生长因子(vascular endothelial growth factor,VEGF)与多发性骨髓瘤(multiple myeloma,MM)临床分型及疗效的关系,分析其临床意义。用酶联免疫吸附法(enzyme-linked immunosorbent assay,ELISA)检测76例MM患者血清VEGF浓度,分析其与MM患者年龄、临床分期、分型、疗效的关系。结果表明,与老年组(>65岁)相比,年轻组(≤65岁)患者血清VEGF水平较高,但两者之间无显著差异(P>0.05)。IgG型患者血清VEGF水平最高,轻链型次之,IgA型最低,但各组之间无显著差异(P>0.05)。DS分期Ⅲ期患者血清VEGF水平较Ⅱ期患者有增高趋势,但两者间差异无显著性(P>0.05)。ISS分期Ⅰ期患者VEGF水平较Ⅱ/Ⅲ期患者低,但也未见明显差异(P>0.05)。MM患者经治疗后,获得完全缓解(complete remission,CR)或非常好的部分缓解(very good partial remission,VGPR)的患者VEGF水平较治疗前有所降低,而获得PR以下疗效患者的VEGF水平则较治疗前有所升高。根据VEGF的血清水平(≤150 ng/L)将患者分为2组,2组之间中位生存期(overall survival,OS)存在明显差异(P<0.05),VEGF水平高的患者生存期明显缩短。结论:MM患者血清VEGF水平与患者年龄、分期和分型无明确关系,但与MM患者疗效及生存期具有相关性,是MM患者的危险预后因素。This study was purposed to investigate the relation of serum vascular endothelial growth factor （VEGF）levels with clinical types and therapeutic efficacy of multiple myeloma （MM）,and to analyze the significance of VEGF in MM.The levels of serum VEGF were detected by enzyme-linked immunosorbent assay（ELISA） technique in 76 patients with MM.The relationship between the serum VEGF levels with MM patients＇age,stages,types,and efficacy were analyzed.The results showed that the patients who were less than 65 years old had higher serum VEGF levels than elder patients,however,the difference between them had no statistical significance（P ＞ 0.05）.The VEGF level was the highest in IgG type patients,and then in light chain type,lowest in IgA type,however there were no statistical differences between them（P ＞ 0.05）.Patients of DS stage Ⅲ had higher VEGF level than that of stage Ⅱ,and there was also no statistical difference （P ＞ 0.25）.Patients of ISS stage Ⅰ had lower VEGF level than that of stage Ⅱ and Ⅲ,and it also showed no statistical difference （P ＞ 0.05）.After treatment,patients obtained complete remission （CR） or very good partial remission （VGPR） had decrease of serum VEGF level,however,patients obtained less than partial remission （PR） had increase of serum VEGF level.Patients were divided into two groups according serum VEGF level （≤150 ng/L）,patients with high VEGF levels had short overall survival time,there was statistical difference （P =0.03）.It is concluded that the serum VEGF level of MM patients dose not relate with age,clinical stages and M protein types; however,there was a certain association between overall survival and serum VEGF level,and the later may be one of poor prognostic factors.

关 键 词：多发性骨髓瘤 血管内皮生长因子 多发性骨髓瘤预后 

分 类 号：R733.3[医药卫生—肿瘤]