白细胞介素6、肿瘤坏死因子α和Dickkopf1在多发性骨髓瘤中的表达及临床意义

Expressions of interleukin 6,tumor necrosis factor α and Dickkopf1 in multiple myeloma and their clinical significance

目的目前,已发现骨髓造血微环境对骨髓瘤的发病起重要的作用。骨髓基质细胞和骨髓瘤细胞分泌多种细胞因子,如白细胞介素6(IL-6)、肿瘤坏死因子α(tumor necrosis factorα,TNF-α)、Dickkopf1(DKK1)等,对疾病进展及预后非常重要。文中探讨多发性骨髓瘤(multiple myeloma,MM)患者血清IL-6、TNF-α、DKK1的表达及其临床意义。方法采用ELISA法测定39例MM患者与10名健康对照者血清中IL-6、TNF-α、DKK1的水平。将患者分为初发及进展期组和稳定期组2组进行分析。结果初发及进展期组血清IL-6、TNF-α水平明显高于稳定期和对照组,IL-6分别为(45.30±42.11)pg/ml(初发及进展期组)、(19.64±14.06)pg/ml(稳定期组)、(12.62±14.71)pg/ml(对照组),P<0.05。TNF-α分别为(8.72±5.46)pg/ml(初发及进展期组)、(4.77±2.45)pg/ml(稳定期组)、(4.97±2.52)pg/ml(对照组),P<0.05。稳定期与对照组患者血清IL-6、TNF-α水平无统计学差异。初发及进展期组血清DKK1水平与对照组比较有统计学差异,稳定期组患者血清DKK1水平与对照组比较无统计学差异。DKK1分别为(12825.40±9136.55)pg/ml(初发及进展期组)、(6847.11±4374.93)pg/ml(稳定期组)、(2973.66±877.84)pg/ml(对照组),P<0.05。结论血清IL-6、TNF-α、DKK1的水平可能与MM的发生、发展有关。测定血清IL-6、TNF-α、DKK1水平对于MM病情评估和监测治疗效果有一定意义。

Objective Bone marrow microenvironment plays an important role in the incidence of multiple myeloma （MM）. Bone marrow stromal cells and myeloma cells secrete a variety of cytokines such as interleukin 6 （IL-6）, tumor necrosis factor a （TNF-a）, and Dickkopfl （DKK1）, which are very important for the progression and prognosis of diseases. This study aimed to investigate the clinical application of the serum concentrations of IL-6, TNF-a and DKK1 in MM patients. Methods We determined the levels of serum IL-6, TNF-a and DKK1 in 39 MM patients and 10 normal control subjects by ELISA. We divided the patients into an initial and progressive （IP） group and a stable group, and made a comparative analysis between the two groups. Results The levels of serum IL-6 and TNF-a were significantly higher in the IP group （ [45.30±42.11 and 8.72±5.46] pg/ml） than that in the stable and control groups （ [ 19.64±14.06 and 12.62± 14.71 ] pg,/ml, [ 4.77 ±2.45 and 4.97 ± 2.52 ] pg/ml） （P 〈 0.05）, with no statistically significant differ- ences between the latter two （P 〉 0.05）. The level of serum DKK1 was also significantly higher in the IP than that in the control group （ [ 12825.40 ± 9136.55 vs 2973.66 ± 877.84 ] pg/ml, P 〈 0.05 ）, but with no significant difference between the stable and control groups （P 〉 O. 05）. Conclusion The levels of serum IL-6, TNF-a and DKK1 may be associated with the occurrence and progression of multiple myeloma, and the determination of their levels contributes to the diagnosis of the disease and evaluation of its response to treatment.