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

Clinical Significance of Serum Vascular Endothelial Growth Factor and Interleukin-17 in Patients with Multiple Myeloma

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。

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 stageⅠ,18 in stageⅡ,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（P0.01）.VEGF and IL-17 levels in stage Ⅲ was significantly higher than that in stage Ⅰ and Ⅱ（P0.05）.There was a positive correlation between IL-17 and serum calcium β2-microglobulin or C-reactive protein（P0.01）,and there was also a positive correlation between VEGF and serum creatinine serum Bene-Jones protein λ or urinary Bene-Jones protein λ（P0.01）. 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.