老年AML患者在经地西他滨治疗中COX⁃2、VEGF及p53蛋白的表达及与预后关系  

Expressions of COX-2,VEGF and p53 in elderly AML patients treated with decitabine and their prognosis

作　　者：王战芳[1] 张芳芳 杨海[1] 陈超华[1] WANG Zhanfang;ZHANG Fangfang;YANG Hai;CHEN Chaohua(Department of Hematology,the First People's Hospital of Pingdingshan,Pingdingshan,Henan,China,467000)

机构地区：[1]平顶山市第一人民医院血液科,河南平顶山467000

出　　处：《分子诊断与治疗杂志》2020年第4期520-524,共5页Journal of Molecular Diagnostics and Therapy

基　　金：平顶山市教育科技基金HGF-20165021358。

摘　　要：目的探究老年急性髓细胞白血病(AML)在经地西他滨治疗中血清环氧化酶2(COX⁃2)、血管内皮生长因子(VEGF)、p53蛋白的表达及对预后的预测价值。方法选取本院2014年1月至2019年1月收治的80例AML患者作为研究组,并选取同期于本院健康体检者40例作为对照组,对比研究组治疗前后及对照组COX⁃2、VEGF、p53蛋白、体液免疫和细胞免疫水平,分析各指标的相关性;根据患者治疗后分为完全缓解组(n=48)和未完全缓解组(n=32),对比两组COX⁃2、VEGF、p53蛋白水平,并比较两组中枢神经系统白血病(CNSL)的发生率;受试者工作特征曲线(ROC)分析COX⁃2、VEGF、p53蛋白在AML患儿预后中的预测价值。结果研究组患者COX⁃2、VEGF及p53蛋白水平均显著高于对照组,差异具有统计学意义(P<0.05);研究组患者COX⁃2、VEGF及p53蛋白水平治疗后均较治疗前明显降低,差异具有统计学意义(P<0.05)。研究组患者治疗后体液免疫指标IgA、IgG、IgM水平均较治疗前明显降低,差异具有统计学意义(P<0.05);研究组患者治疗后细胞免疫指标CD3+、CD4+、CD8+、CD4+/CD8+均较治疗前明显降低,差异具有统计学意义(P<0.05)。相关性分析结果显示,COX⁃2、VEGF及p53蛋白之间存在明显正相关性(P<0.05)。完全缓解组和未完全缓解组AML患者COX⁃2、VEGF及p53蛋白水平比较差异具有统计学意义(P<0.05)。完全缓解组和未完全缓解组AML患者中位生存期比较差异具有统计学意义(P<0.05)。ROC曲线结果显示,COX⁃2、VEGF、p53蛋白及联合检测在CNSL诊断中的曲线下面积(AUC)分别为0.836(95%CI:0.776~0.896)、0.802(95%CI:0.730~0.873)、0.716(95%CI:0.639~0.793)及0.905(95%CI:0.863~0.947)。结论COX⁃2、VEGF及p53蛋白水平检测对于老年AML患者临床治疗效果观测及预后评估具有显著价值。Objective To investigate the expression of serum cyclooxygenase 2(COX⁃2),vascular endothelial growth factor(VEGF)and p53 protein in elderly patients with acute myeloid leukemia(AML)treated with decitabine and their prognostic value.Methods 80 patients with AML admitted to our hospital from January 2014 to January 2019 were selected as the study group,and 40 healthy people who underwent physical examination in our hospital were selected as the control group.The levels of COX⁃2,VEGF,p53 protein,humoral immunity and cellular immunity in the study group before and after treatment and the control group were compared and the correlation of indexes were also analyzed.According to the patients after treatment,they were divided into complete remission group(n=48)and incomplete remission group(n=32).The levels of COX⁃2,VEGF,p53 protein in the two groups were analyzed.The incidence of central nervous system leukemia(CNSL)between the two groups was compared.The predictive value of COX⁃2,VEGF,and p53 protein in the prognosis of AML was analyzed using the receiver operating characteristic curve(ROC).Results The levels of COX⁃2,VEGF,and p53 proteins in the study group were significantly higher than those in the control group,and the difference was statistically significant(P<0.05).However,after treatment,the levels of COX⁃2,VEGF,and p53 protein in the study group were significantly lower than those before treatment.The difference was statistically significant(P<0.05).After treatment,the levels of humoral immune indicators IgA,IgG,and IgM in the study group were significantly lower than before treatment(P<0.05).After treatment,the cell immune indicators of CD3+,CD4+,CD8+,and CD4+/CD8+in the study group were significant lower than before treatment(P<0.05).Correlation analysis indicates that there is a significant positive correlation between COX⁃2,VEGF and p53 proteins(P<0.05).The difference in COX⁃2,VEGF and p53 protein levels between AML patients in complete remission group and incomplete remission group was sta

关 键 词：急性髓细胞白血病 老年 环氧化酶2 血管内皮生长因子 p53蛋白 

分 类 号：R733.71[医药卫生—肿瘤]