COX-2、bFGF及TGFβ1在慢性粒细胞白血病中的表达及其意义  

Expression and significance of serum COX-2,bFGF and TGFβ1 in chronic myeloid leukemia

作　　者：王晓军[1] 茹甫毅 吴双有[1] 朱卫民[1] 田培军[1] 

机构地区：[1]安康市中心医院,陕西安康725000

出　　处：《现代肿瘤医学》2017年第4期603-607,共5页Journal of Modern Oncology

基　　金：陕西省卫生科研项目(编号:D80)

摘　　要：目的:检测不同分期慢性粒细胞白血病(chronic myeloid leukemia,CML)患者血清环氧合酶-2(serum cyclooxygenase-2,COX-2)、碱性成纤维细胞生长因子(basic fibroblast growth factor,b FGF)及转化生长因子(transforming growth factorβ1,TGFβ1)的变化,并探讨其在CML的诊治及预后判定中的临床意义。方法:以在安康市中心医院就诊的50例初诊患者(其中慢性期30例,加速期10例,急变期10例)为研究对象,以该院体检中心健康体检者40例为正常对照,采用ELISA方法检测血清COX-2、b FGF及TGFβ1水平,并对CML患者进行治疗前、后两个不同阶段的动态检测。结果:初诊时,CML组患者的血清COX-2及b FGF含量显著升高,而TGFβ1含量明显减低(P<0.001)。CML组加速期和急变期患者血清b FGF及COX-2水平较慢性期患者均明显增高,而TGFβ1水平均显著减低,差异有统计学意义。完全缓解(complete response,CR)时,血清b FGF及COX-2含量明显下降,而TGFβ1含量基本恢复到正常水平,与正常对照组相比较,差异无统计学意义(P>0.05);未达到缓解时,血清b FGF、COX-2及TGFβ1水平与CR组比较差异显著(均为P<0.001)。CML初诊患者治疗前血清b FGF、VEGF水平与TGFβ1呈负相关(分别为r=-0.330,P=0.020;r=-0.632,P<0.001)。结论 :CML患者初诊时COX-2及b FGF高表达,TGFβ1低表达,经过甲磺酸伊马替尼治疗后,达到CR时,血清这些因子水平基本恢复正常,提示C ML的发生、发展与这些因子密切相关。因此,动态监测CML患者血清COX-2、b FGF及TGFβ1水平,可作为CML病情评估的重要参考指标。Objective： To measure the serum levels of COX- 2,b FGF,TGFβ1 and VEGF in patients at different stages of chronic myeloid leukemia,and study the diagnosis,treatment and prognosis of the disease. Methods： The serum levels of COX- 2,b FGF,TGFβ1 and VEGF in 50 chronic myeloid leukemia patients and 40 healthy adults were determined by ELISA,and the results were analyzed at different stages of the disease. Results： Compared with the normal control group,the plasma levels of b FGF and COX- 2 were found to be elevated before treatment in the chronic myeloid patients（ P〈0. 001）. Also,compared with the normal control group,plasma levels of TGFβ1 were found to be decreased before treatment in chronic myeloid leukemia patients（ P〈0. 001）. Yet when the chronic phase group was compared with the accelerated phase group,differences were found in the levels of COX- 2,b FGF and TGFβ1（ P〈0. 001）. Also,when the chronic phase group was compared with the blast crisis group,differences were again found in the levels of COX- 2,b FGF and TGFβ1（ P〈0. 001）. Compared with the normal control group,no differences were found in the serum levels of COX- 2,b FGF and TGFβ1 in the patients with chronic myeloid leukemia after complete remission（ CR）. Compared with the no remission group,differences were found in the serum levels of COX- 2,b FGF and TGFβ1 in the patients with chronic myeloid leukemia after complete remission（ CR）（ P〈0. 001）. Finally,a negative correlation was found in the serum levels of COX- 2,b FGF and TGFβ1 in the patients with chronic myeloid leukemia（ r =- 0. 330,P = 0. 020,r =- 0. 632,P〈0. 001）. Conclusion： Our study showed the serum levels of angiogenesis- promoting factors COX- 2 and b FGF to be elevated,the serum levels of TGFβ1 to be decreased before treatment in chronic myeloid patients,but after complete remission,the serum levels of these angiogenic factors were found to be returned to normal. Angiogenesis may play a role in the leukemogenic process. Therefore

关 键 词：慢性粒细胞白血病 环氧合酶-2(COX-2) 碱性成纤维细胞生长因子(bFGF) 转化生长因子(TGFβ1) 

分 类 号：R733.7[医药卫生—肿瘤]