急性白血病患者化疗前后外周血IL-2、TNF-α和VEGF水平变化及与临床预后的关系

Relationship of Levels of Peripheral Blood IL-2, TNF- a and VEGF with Clinical Prognosis in Patients with Acute Leukemia Before and After Chemotherapy

目的:探讨急性白血病患者(AL)化疗前后外周血白细胞介素-2(IL-2)、肿瘤坏死因子-α(TNF-α)、血管内皮生长因子(VEGF)水平变化及与临床预后的关系。方法:选2010年3月-2013年12月在我院行化疗治疗的53例AL患者(AL组),并同期抽选我院47例健康体检者为对照组,采用放射免疫以及酶联法检测两组外周血IL-2、TNF-α和VEGF水平,并探讨AL患者化疗前后外周血IL-2、TNF-α、VEGF水平变化及与临床预后的关系。结果:AL组化疗前外周血TNF-α、VEGF水平明显高于对照组(P<0.05),IL-2水平明显低于对照组(P<0.05)。AL组化疗6个月后外周血IL-2、TNF-α和VEGF含量与化疗前比较差异均有统计学意义(P<0.05)。AL组化疗6个月后长期缓解未复发者42例、复发者11例;复发患者的外周血TNF-α、VEGF水平较未复发组高,IL-2较未复发组低,组间差异具有统计学意义(P<0.05)。结论:检测AL患者的外周血IL-2、TNF-α、VEGF含量可作为诊断及判断预后的重要指标。

Objective： To investigate the levels of peripheral blood IL-2, TNF-α and VEGF and their relationship with clinical prognosis in patients with acute leukemia （AL） before and after chemotherapy. Method： A total of 53 patients with AL, who were given chemotherapy in Ruijin Hospital from March 2010 to December 2013, were chosen as AL group, and 47 healthy subjects, as control group. Radioimmunoassay and ELISA were used to detect the levels of peripheral blood IL-2, TNF- a and VEGF of the two groups,and the levels of peripheral blood IL-2, TNF- a and VEGF and their relationship with clinical prognosis in patients with AL before and after chemotherapy were investigated. Results： The levels of peripheral blood TNF-α and VEGF of AL group before chemotherapy were significantly higher than that of control group （P〈0.05）, while levels of IL-2 of AL group was significantly lower than that of control group （P〈0.05）. The levels of peripheral blood IL-2 and TNF-α and VEGF after six months＇ chemotherapy in AL group had statistically significant difference compared with before chemotherapy （P〈0.05）. There were 42 cases of long term remission without recurrence in AL group after six months＇ chemotherapy, while 11 cases of recurrence; levels of peripheral blood TNF-α and VEGF of the patients with recurrent were higher than that of the patients without recurrent, but the level of IL-2 of the patients with recurrent was lower than that of the patients without recurrent. There was statistical difference between the two groups （P〈0.05）. Conclusion： Detecting the levels of IL-2, TNF-α and VEGF in the peripheral blood of AL patients can be used as the important indexes in diagnosis and prognosis.