Prohepcidin、新喋呤在实体肿瘤贫血病人促红细胞生成素治疗前后的变化

The changes of prohepcidin and neopterin before and after EPO treatment in anemia patients with solid tumors

目的探讨实体肿瘤贫血病人血清新喋呤、hepcidin的前体肽(prohepcidin)与促红细胞生成素(EPO)、铁蛋白、C反应蛋白(CRP)等指标的相关性。方法将2009年1月至2010年12月收治的实体肿瘤贫血病人按入组条件纳入治疗组30例,予EPO治疗皮下注射6000IU,每周3次,疗程1个月;同时设良性贫血对照组30例;健康对照组30例。治疗组治疗前后及良性贫血对照组贫血纠正前后,检测新喋呤、prohepcidin、EPO、铁蛋白、CRP、Hb;健康对照组检测新喋呤、prohepcidin、EPO。结果治疗组治疗前新喋呤水平明显高于良性贫血对照组及健康对照组(P=0.000);治疗后明显高于良性贫血对照组(P=0.007)。治疗组治疗前prohepcidin稍低于良性贫血对照组及健康对照组,但差异无统计学意义(P=0.335);治疗后无明显变化,稍低于良性贫血对照组(P=0.409)。治疗前后比较,治疗组、良性贫血对照组的新喋呤、prohepcidin水平差异无统计学意义(P均>0.05)。相关性分析显示,仅良性贫血对照组治疗后新喋呤与VitB12水平有明显相关性(r=0.883,P=0.001);余治疗组、良性贫血对照组治疗前后的prohepcidin与CRP、铁蛋白、EPO水平之间及治疗组治疗前后的新喋呤与VitB12、铁蛋白水平之间,均无相关性(P均>0.05)。结论 prohepcidin不能作为hepcidin检测的替代物;良性贫血与实体肿瘤性贫血患者之间新喋呤水平差异有统计学意义,可用于辅助鉴别贫血病因。

Objective To explore the correlation of serum neopterin and prohepcidin （a precursor peptide of hepci- din） with erythropoietin （EPO）, ferritin, C-reactive protein （CRP） and other related indicators in anemia patients with solid tumors. Methods Eligible studied objects were grouped as follows： 30 anemia patients with solid tumors received EPO treat- ment （ EPO 6 000IU, ih, three times a week for one month ） from January 2009 to December 2010 were included in treatment group; 30 cases of benign anemia （routine treatment of anemia）were served as benign anemia control group; 30 healthy sub- jects were selected as healthy control group. In treatment group and benign anemia control group, neopterin, prohepcidin, EPO, ferritin, CRP and hemoglobin （Hb） were detected before and after treatment or correcting anemia, respectively. Neop- terin, prohepeidin and EPO were detected in healthy control group. Results In the treatment group, neopterin level before treatment was significantly higher than those in benign anemia control group and the healthy control group （P =0. 000） and its level after treatment was significantly higher than that in benign anemia control group （ P = 0. 007 ）. Prohepeidin level before treatment in treatment group slightly lower than those in benign anemia control group and healthy control group, but the differ- ence was not statistical significant （ P = 0. 335 ） ; its level after treatment was still slightly lower than those in benign anemia control group and healthy control group （P = 0. 409）. In treatment group and benign anemia control group, there were no signifi- cant differences on the levels of neopterin and prohepeidin before and after treatment （ P 〉 O. 05 ）. The correlation analysis showed that the neopterin level after treatment was close correlated with VitBt2 level in the benign anemia control group only（r =0.883 ,P = 0. 001 ） ;the prohepcidin levels before and after treatment in treatment group and benign anemia control group were not correlated with the levels of CRP, ferritin, EPO, and the neopterin levels before and after treatment in treatment group were not correlated with the levels of VitBl2 and ferritin （ all P 〉 0. 05 ）. Conclusions Prohepcidin detection can not be used as a substitute of hepcidin detection. There is significant difference on neopterin level between benign anemia and anemia of solid tumors, and it can be used as an assist for identifying the cause of anemia.