POEMS综合征血清血管内皮生长因子检测意义

Detection of Vascular Endothelial Growth Factor in POEMS Syndrome

目的探讨血清血管内皮生长因子(VEGF)在POEMS综合征中的临床意义。方法采用ELISA方法检测POEMS综合征组(36例)、疾病对照组(多发性骨髓瘤29例、格林巴利综合征7例共36例)、正常对照组(36例)的血清VEGF浓度,进行组间比较,并与临床资料进行相关性分析。结果 POEMS综合征组血清VEGF浓度为(982.06±611.49)pg/ml,显著高于疾病对照组[(364.22±264.37)pg/ml]和正常对照组[(217.37±87.74 pg/ml)],P<0.001。VEGF诊断POEMS综合征曲线下面积为0.902,VEGF Cutoff值为360.62 pg/ml,敏感性为0.889,特异性为0.764。POEMS综合征组血清VEGF与肺动脉高压、外周血小板计数相关,与其他临床表现无显著相关性。结论血清VEGF浓度升高是POEMS综合征的一个重要特征,有助于POEMS综合征的诊断;血清VEGF浓度与肺动脉高压有一定相关性,可能是肺动脉高压发病机制之一。

Objective To explore the significance of vascular endothelial growth factor（VEGF） in POEMS syndrome.Methods Thirty six serum samples of these patients who were diagnosed as POEMS syndrome in our hospital during 2005-2009 were collected.Thirty six serum samples of blood donors were collected as healthy control,and 29 serum samples of Multiple Myeloma and 7 serum samples of Guillain-Barre syndrome were collected as disease control.VEGF was detected in all groups and compared with each other.A correlation between VEGF levels and clinical manifestations was also studied.Results The mean concentration of VEGF in POEMS syndrome group,which is 982.06±611.49 pg/ml,was higher than healthy control group and disease control group.The diagnostic Area Under Curve（AUC） was 0.902,cutoff value 360.62 pg/ml,sensitivity 0.889,specificity 0.764,respectively.Serum concentration of VEGF was positively correlated with pulmonary artery hypertension,while not significantly correlated with endocrinopathy,organmegaly,skin changes,pleural effusion,ascites,and papilledema.Serum concentration of VEGF is positively correlated with platelets counts,while not significantly correlated with WBC,ESR or CRP.Conclusion The elevation of serum VEGF is an important characteristic of POEMS syndrome and useful in diagnosis of it.Serum VEGF is positively correlated with pulmonary artery hypertension,and maybe involved in the pathogenesis of pulmonary artery hypertension in POEMS syndrome.