多发性骨髓瘤患者骨髓上清液和血清DKK1表达水平及其临床意义

目的 分析研究多发性骨髓瘤(multiple myeloma,MM)患者骨髓上清液和血清Wnt通路抑制因子Dickkopf-1(DKK1)表达水平,探讨DKK1在多发性骨髓瘤中的临床意义。 方法 本研究对象为2014—2015年新疆医科大学第一附属医院门诊及住院的20例MM初治患者和10例缺铁性贫血初治患者。实验方法采用双抗体夹心酶标免疫分析法(ELISA)检测20例初治MM患者(MM组)及10例缺铁性贫血初治患者(对照组)的骨髓上清液及血清DKK1表达水平。 结果 MM患者骨髓上清液DKK1水平为(8.9±2.8) ng/ml,对照组患者骨髓上清液DKK1水平为(1.3±0.9) ng/ml;MM患者外周血血清DKK1水平为(8.7±2.2) ng/ml,对照组患者外周血血清DKK1水平为(1.0±0.5) ng/ml。MM组骨髓上清液及血清DKK1表达水平与对照组之间比较差异有统计学意义(P=0.001)。MM组骨髓上清液和MM组血清的DKK1表达水平比较差异无统计学意义(P>0.05)。 结论 MM患者骨髓上清液DKK1表达水平明显高于对照组。MM患者外周血血清DKK1表达水平明显高于对照组。MM患者的骨髓上清液和外周血血清DKK1表达水平差异无统计学意义。本研究揭示了能造成成骨细胞功能改变,活性减弱,加速破骨细胞分化,抑制成骨前体细胞亢进分化的DKK1是骨髓瘤骨病发生的重要因素。DKK1的表达水平高低与溶骨性病变相关。 

Expression levels and clinical significance of DKK1 in bone marrow supernatant and blood serum of patients with multiple myeloma

Objective To study the expression levels of Dickkopf-1 (DKK1) in bone marrow supernatant and blood serum of patients with multiple myeloma (MM), and to investigate the clinical significance of DKK1 in multiple myeloma. Methods Twenty cases of multiple myeloma (MM group) and 10 cases of iron deficiency anemia (control group) in our hospital between 2014 and 2015 were enrolled into this study. The expression levels of DKK1 in bone marrow supernatant and blood serum were tested by using antibody sandwich enzyme linked immunoassay (ELISA). Results The level of DKK1 in the bone marrow supernatant of MM group was (8. 9 ±2. 8) ng/ml and of the control group was (1. 3 ±0. 9) ng/ml; in serum of MM group was (8. 7 ±2. 2) ng/ml and of the control group was (1. 0 ±0. 5) ng/ml, there was a significant difference between the two groups (P=0. 001). There was no significant difference between supernatant and blood serum in MM group (P > 0. 05). Conclusion The DKK1 levels of bone marrow supernatant and blood serum of patients with MM are all significantly higher than those in the control group. DKK1 secreted by myeloma cells is an important factor leading to the osteopathia in MM patients. The level of DKK1 is related to the osteolytic lesions.