多发性骨髓瘤患者血清血管内皮生长因子和白介素-17水平变化的临床意义

本研究旨在探讨多发性骨髓瘤患者血清中血管内皮生长因子(VEGF)和白介素-17(IL-17)水平变化的临床意义。初治MM患者40例,其中临床Ⅰ期9例,Ⅱ期18例,Ⅲ期13例。在40例中25例采用长春新碱、阿霉素和地塞米松(VAD)方案治疗,15例采用硼替佐米和地塞米松(BD)方案治疗。正常对照组20例。用ELISA方法检测化疗前后血清VEGF和IL-17的水平。结果表明,MM组的VEGF和IL-17水平明显高于正常对照组(P<0.01),且随着临床分期,VEGF水平和IL-17水平呈递增趋势(P<0.05)。VEGF和IL-17水平在Ⅲ期高于Ⅰ期组和Ⅱ期组(P<0.05)。MM患者血清VEGF水平、血肌酐、血轻链λ、尿轻链λ、IL-17水平、C反应蛋白、血钙、β2-微球蛋白水平等均明显高于正常对照组(P<0.01)。治疗后VEGF和IL-17水平较治疗前明显下降(P<0.05),BD方案化疗效果较VAD方案更为显著(P<0.05)。结论:检测血清VEGF和IL-17水平对于MM患者的临床分期、病情判断和疗效观察具有重要意义。

Clinical significance of serum vascular endothelial growth factor and interleukin-17 in patients with multiple myeloma

The aim of this study was to investigate the clinical significance of vascular endothelial growth factor (VEGF) and interleukin-17 (IL-17) levels in patients with multiple myeloma (MM). 40 newly diagnosed MM patients were enrolled, including 9 in stage I, 18 in stage II, 13 in stage III. 25 patients were treated with VAD regimen, and 15 patients with the bortezomib and dexamethasone (BD) regimen. 20 healthy individuals as controls were enrolled in this study. The serum VEGF and IL-17 levels were determined by ELISA. The results indicated that the serum VEGF and IL-17 levels in the patients with MM were significantly higher than those in healthy controls (P < 0.01). VEGF and IL-17 levels in stage III was significantly higher than that in stage I and II (P < 0.05). There was a positive correlation between IL-17 and serum calcium β2-microglobulin or C-reactive protein (P < 0.01), and there was also a positive correlation between VEGF and serum creatinine serum Bene-Jones protein λ or urinary Bene-Jones protein λ (P < 0.01). Serum VEGF and IL-17 levels significantly decreased in MM patients after treatment, and the serum levels of VEGF and IL-17 was much lower in MM patients treated with VAD regimen than those in patients treated with BD regimen. It is concluded that the detection of serum VEGF and IL-17 levels is helpful to evaluation of the clinical stages and the severity of MM.