检测非霍奇金淋巴瘤患者外周血CD14+单核细胞组织因子和血管内皮生长因子的临床意义

Clinical Significance of Tissue Factor and Vascular Endothelial Growth Factor Expressions on CD14+ Monocytes in Patients with Non-Hodgkin Lymphoma

目的探讨非霍奇金淋巴瘤(NHL)患者外周血CD14+单核细胞表面组织因子(TF)和血管内皮生长因子(VEGF)表达在病情评估、预后及短期疗效评价中的意义。方法采用流式细胞术检测47例NHL患者(病例组)化疗前、化疗4周期后及30例健康者(对照组)外周血CD14+单核细胞TF和VEGF的表达,并分析TF及VEGF表达与国际预后指数及短期疗效的潜在关系。结果 NHL患者外周血CD14+单核细胞TF和VEGF表达量显著高于对照组(P均<0.01),TF和VEGF的表达呈正相关(r=0.708,P=0.00)。Ann Arbor分期Ⅲ/Ⅳ期(22/19例)、有全身症状(22例)、乳酸脱氢酶升高(21例)、体力状态分级2～4级(12例)及结外病灶数>1(16例)的NHL患者CD14+单核细胞TF和VEGF表达量显著高于Ann Arbor分期Ⅱ期(6例)、无全身症状(25例)、乳酸脱氢酶正常(26例)、体力状态分级0～1级(35例)及结外病灶数≤1者(31例)(P均<0.05)。高中危组(11例)及高危组(7例)外周血CD14+单核细胞TF和VEGF表达量均显著高于低危组(15例)及低中危组(14例)(P均<0.01)。化疗前未缓解组(11例)外周血CD14+单核细胞TF和VEGF表达量显著高于缓解组(36例)(P均<0.01)。化疗后缓解组两者表达较化疗前明显降低(P均<0.01),但是未缓解组两者表达与化疗前的差异无统计学意义(P均>0.05)。结论外周血CD14+单核细胞TF和VEGF高表达可作为NHL病情评估、预后评价以及短期疗效观察的指标之一。

Objective To explore the values of tissue factor（TF） and vascular endothelial growth factor（VEGF） expressions on peripheral CD14＋ monocytes in disease assessment,prognosis,and short-term efficacy evaluation of non-Hodgkin lymphoma（NHL） patients.Methods TF and VEGF expressions on CD14＋ monocytes in 47 NHL patients（disease group） before chemotherapy and after 4 chemotherapy cycles and in 30 healthy subjects（control group） were detected by flow cytometry,and the potential relationship among TF,VEGF,International Prognostic Index（IPI）,and short-term efficacy were analyzed.Results TF and VEGF expressions on CD14＋ monocytes in disease group were significantly higher than those in control group（all P0.01） and positive correlation was showed between them（r=0.708,P=0.00）.TF and VEGF expressions in Ann Arbor stage Ⅲ and Ⅳ（n=22 and 19）,symptomatic（n=22）,lactate dehydrogenase（LDH） increased（n=21）,Eastern Cooperative Oncology Group（ECOG） score 2-4（n=12） and extranodal lesions1（n=16） groups were significantly higher than those in Ann Arbor stage Ⅱ（n=6）,asymptomatic（n=25）,LDH normal（n=26）,ECOG score 0-1（n=35） and extranodal lesions ≤1（n=31） groups,respectively（all P0.05）.The expressions of TF and VEGF on CD14＋ monocytes in high-risk（n=7） or high-middle-risk（n=11） groups were significantly increased compared with low-risk（n=15） or low-middle-risk（n=14） groups,respectively（all P0.01）.TF and VEGF expressions in non-remission group before chemotherapy（n=11） were both obviously higher than those in remission group（n=36,all P0.01）,and after chemotherapy their expressions in remission group were significantly lower than those before chemotherapy（all P0.01）,while such significant changes were not observed in the non-remission group（all P0.05）.Conclusion The high expressions of TF and VEGF on peripheral CD14＋ monocytes can be useful markers in disease assessment,prognosis evaluation and short-term efficacy observation of NHL patients.