SDF-1、CXCR4表达及MVD与多发性骨髓瘤预后的关系

Correlation of SDF-1 and CXCR4 expressions and MVD with the prognosis of multiple myeloma

目的 :探讨多发性骨髓瘤组织中基质细胞衍生因子-1(stromal cell-derived factor-1,SDF-1)及其受体趋化因子C-X-C基元受体4[chemokine(C-X-C motif)receptor 4,CXCR4]表达和微血管密度(microvessel density,MVD)对患者预后的影响。方法:应用免疫组化法检测78例多发性骨髓瘤患者及30例正常人骨髓组织中SDF-1和CXCR4的表达情况及MVD。分析患者年龄、性别、国际分期系统(international staging system,ISS)分期、免疫球蛋白分型、轻链分类、SDF-1表达、CXCR4表达及MVD与多发性骨髓瘤患者预后的关系。结果:多发性骨髓瘤组织中SDF-1表达量与CXCR4表达量及MVD计数呈正相关(P值均<0.01)。多发性骨髓瘤患者SDF-1表达量、CXCR4表达量及MVD计数与其诱导治疗方案无相关性(P值均>0.05)。KaplanMeier分析结果显示,多发性骨髓瘤患者中SDF-1和CXCR4低表达者的总生存率及无进展生存率均高于二者高表达的者(P值均<0.05),低MVD者的总生存率及无进展生存率均高于高表达者(P值均<0.05)。年龄、SDF-1、CXCR4表达及MVD是多发性骨髓瘤患者预后的独立影响因素(P值均<0.05)。结论:SDF-1、CXCR4表达及MVD是多发性骨髓瘤患者预后的独立影响因素,SDF-1、CXCR4及MVD可能在多发性骨髓瘤恶性进展中起促进作用,将来有望成为多发性骨髓瘤治疗的新靶点。

Objective： To investigate the expressions of stromal cell-derived factor-1 （SDF-1） and its receptor chemokine （C-X-C motif） receptor 4 （CXCR4） as well as the microvessel density （MVD） in patients with multiple myeloma, and to explore their effects on the prognosis.Methods： The expressions of SDF-1 and CXCR4 as well as MVD in bone marrow from 78 patients with multiple myeloma and 30 normal persons were detected by immunohistochemical method. The correlations of age, gender, international staging system （ISS） staging, immunoglobulin typing, light chain classification, SDF-1 expression, CXCR4 expression and MVD with the prognosis of multiple myeloma patients were analyzed. Results： The expression of SDF-1 in bone marrow of multiple myeloma patients was positively correlated with the expression of CXCR4 and the count of MVD （both P 〈 0.01）. The expression levels of SDF-1 and CXCR4 as well as the count of MVD were not correlated with the induction therapy in patients with multiple myeloma （all P 〉 0.05）. The overall survival rate and progression-free survival rate of multiple myeloma patients with low expressions of SDF-1 and CXCR4 were lower than those of patients with high expressions of SDF-1 and CXCR4 （both P 〈 0.05）. The overall survival rate and progression-free survival rate of patients with multiple myeloma in low count of MVD group were higher than those in the high count of MVD group （both P 〈 0.05）. The age, SDF-1 and CXCR4 expressions, and MVD were independent prognostic factors for the patients with multiple myeloma （all P 〈 0.05）. Conclusion： The expressions of SDF-1 and CXCR4 and the count of MVD were independent prognostic factors for the patients with multiple myeloma. SDF-1, CXCR4 and MVD may play promoting roles in the malignant progression of multiple myeloma, so they are expected to become new targets for the treatment of multiple myeloma in the future.