弥漫大B细胞淋巴瘤患者血清肿瘤标志物的表达及其临床意义

Expressions of serum tumor markers in patients with diffuse large B-cell lymphoma and their clinical significances

目的 探讨弥漫大B细胞淋巴瘤（DLBCL）患者外周血中血管内皮生长因子（VEGF）、乳酸脱氢酶（LDH）、糖类抗原125（CA125）及β2微球蛋白（β2-MG）的表达水平及其临床意义.方法选择山西省汾阳医院和山西大医院2011年12月至2013年6月经病理确诊初治DLBCL患者30例及20名健康体检者（对照组）,酶联免疫吸附试验（ELISA）检测外周血中VEGF、CA125及β2-MG的表达水平,速率法测定血清中LDH含量.结果DLBCL患者VEGF、LDH、CA125及β2-MG表达水平均高于健康对照组[（368±194）比（156±48）pg/ml,t=5.718,P=0.000;（487±252）比（177±32）U/L,t=6.658,P=0.000;（58±16）比（19±10）U/ml,t=9.701,P=0.000;（3.1±1.5）比（1.6±0.3）mg/L,t=5.612,P=0.000].Ⅲ～Ⅳ期患者血清VEGF、LDH表达水平高于Ⅰ～Ⅱ期[（506±165）比（275±154）pg/ml,t=3.896,P=0.000;（886±433）比（220±86）U/L,t=5.244,P=0.000].有骨髓浸润患者血清VEGF、LDH表达水平高于无骨髓浸润患者[（505±201）比（299±152）pg/ml,t=3.148,P=0.004;（798±463）比（331±166）U/L,t=3.113,P=0.005].有A症状患者血清VEGF、LDH表达水平与有B症状患者差异无统计学意义（均P〉0.05）.DLBCL患者血清CA125及β2-MG表达水平在临床分期,有A、B症状亚组及有无骨髓浸润亚组差异均无统计学意义（均P〉0.05）.DLBCL患者VEGF与LDH表达呈正相关（r=0.458,P〈0.05）.结论DLBCL患者高表达VEGF、LDH、CA125及β2-MG,VEGF、LDH表达水平与临床分期、疾病进展及侵袭过程密切相关.联合检测VEGF、LDH可能成为预测DLBCL患者骨髓侵犯的指标.

Objective To investigate the expression levels of serum vascular endothelial growth factor （VEGF）, lactate dehydrogenase （LDH）, sugar chain antigen-125 （CA125）, and β2-microglobulin （β2-MG） in peripheral blood of patients with diffuse large B-cell lymphoma （DLBCL） and their clinical significances. Methods Thirty cases of DLBCL diagnosed by pathology in Fenyang Hospital of Shanxi Province and Shanxi Dayi Hospital from December 2011 to June 2013, 20 cases of healthy individuals as normal control group were enrolled. The levels of serum VEGF, CA125 and β2-MG in peripheral blood were detected by enzyme-linked immunosorbent assay （ELISA）. Serum levels of LDH were detected by the rate method for measuring. Results The expression levels of VEGF, LDH, CA125 and β2-MG in DLBCL patients were higher than those in the healthy control group [（368±194） vs. （156±48） pg/ml, t=5.718, P=0.000;（487±252） vs. （177±32） U/L, t= 6.658, P= 0.000; （58 ±16） vs. （19 ±10） U/ml, t= 9.701, P= 0.000; （3.1 ±1.5） vs. （1.6 ±0.3 ） mg/L, t=5.612, P=0.000]. The expression levels of serum VEGF and LDH in DLBCL patients with stage Ⅲ-Ⅳ were significantly higher than those in patients with stage Ⅰ-Ⅱ [（506±165） vs. （275±154） pg/ml, t= 3.896, P=0.000; （886 ±433） vs. （220 ±86） U/L, t= 5.244, P= 0.000]. The expression levels of VEGF and LDH in DLBCL patients with bone marrow infiltration were higher than those in patients without bone marrow infiltration [（505±201） vs. （299±152） pg/ml, t= 3.148, P= 0.004; （798±463） vs. （331±166） U/L, t= 3.113, P=0.005]. There were no significant differences in the expression levels of VEGF and LDH between patients with A symptoms and B symptoms （all P〉0.05）. The serum levels of CA125 and β2-MG in the observation group had not relationship with clinical stage, the presence of A or B symptoms and the presence of bone marrow infiltration （all P〉 0.05）. The high expression of VEGF had correlation with the high expression of LDH in the observation group （r=0.458, P〈0.05）. Conclusions The expression levels of VEGF, LDH, CA125 andβ2-MG in DLBCL patients before treatment are high, and the high expression levels of VEGF and LDH are closely related to the clinical stage, disease progression and invasion. Combined detection of VEGF and LDH may be a useful predictor of bone marrow involvement in patients with DLBCL.