血清血管内皮生长因子和白细胞介素-6在多发性骨髓瘤中的临床意义

Clinical significance of serum vascular endothelial growth factor and interleukin-6 in multiple myeloma

目的:探讨多发性骨髓瘤(MM)和实体瘤骨转移患者血清血管内皮生长因子(VEGF)和白细胞介素 (IL) 6水平变化的临床意义。方法:MM组37例,其中临床Ⅰ期7例,Ⅱ期8例,Ⅲ期22例;实体瘤骨转移阳性对 照组8例和正常对照组17例;用ELISA方法检测血清VEGF和IL 6的水平。结果:MM组和实体瘤骨转移组血清 VEGF和IL 6水平明显高于正常对照组(P<0.01),且MM组的VEGF水平明显高于实体瘤骨转移组(P<0.05)。 随着临床分期增加,VEGF和IL 6水平呈递增趋势,VEGF水平在Ⅲ期高于Ⅰ期组和Ⅱ期组(P<0.05),IL 6在Ⅱ期 组高于Ⅰ期组(P<0.05)。各骨损评分组间IL 6水平差异存在显著性(P<0.05)。VEGF与血肌苷,尿轻链λ存 在密切的关系(P<0.01);IL 6与血钙,C反应蛋白存在密切的关系(P<0.01)。IL 6水平在临床参数C反应蛋 白、血钙、β2微球蛋白异常组高于其正常组(P<0.05);而VEGF水平在血肌苷、血轻链λ、尿轻链λ的异常组高于 其正常组(P<0.05)。结论:检测血清VEGF和IL 6水平对于MM患者的诊断及鉴别诊断、临床分期、骨损程度和 病情的判断具有重要意义。

Objective To investigate the clinical significance of the changes of vascular endothelial growth factor (VEGF) and interleukin-6 (IL-6) level in multiple myeloma (MM), solid tumor fo- llowing bone metastasis. Methods Thirty- seven MM patients, including 7 in StageⅠ, 8 in StageⅡ, 22 in Stage Ⅲ, 8 solid tumor with bone metastasis patientsly, and 17 healthy controls were enrolled in this study. The serum VEGF and IL-6 levels were determined by ELISA. Results Serum VEGF and IL-6 concentrations in patients with MM and solid tumor were significantly higher than those of the healthy controls (P<0.01), and the VEGF level was higher in MM than in solid tumor with bone metastasis. There was significant difference in VEGF and IL-6 levels in various clinical stages of MM. VEGF levels in StageⅢ were significantly higher than in StageⅠ(P<0.05) and IL-6 levels in StageⅡwere significantly higher than in StageⅠ(P<0.05). The levels of IL-6 showed great difference according to bone lesion scores (P<0.05). There was a positive correlation between IL-6 and serum calcium or C-reactive protein(P<0.01), and there was a positive correlation between VEGF and serum Cr or urinary Bene-Jones protein λ (P<0.01). The IL-6 levels had significant differences between patients with the normal serum CRP, serum calcium, and β 2-MG and patients with abnormal ones (P<0.05). VEGF levels showed significant differences between the patients with normal serum Cr, serum calcium Bene-Jones protein λ, and urinary Bene-Jones protein λ and patients with abnormal ones (P<0.05). Conclusion Serum VEGF and IL-6 levels are helpful to diagnose the clinical stages, and understand bone lesion and serevity of MM.