血液肿瘤患者血清TNF、TGF-α的水平及临床意义

Alterations in the serum levels of TNF and TGF-α in patients with hematological malignancy and their clinical significance

目的 探究TNF和TGF α在血液肿瘤性疾病中的变化和病情及预后的关系。方法 用放射免疫分析法检测了血液肿瘤性疾病患者 (63例 )和正常健康人 (3 0例 )血清TNF和TGF α水平 ,对治疗前后、病情变化进行了比较。结果 血液肿瘤性疾病患者治疗前TNF水平都明显高于正常组 (P <0 .0 1) ,治疗缓解后比治疗前明显降低 (P <0 .0 1)。急、慢性白血病和非何杰金氏淋巴瘤患者治疗前血清TGF α水平都明显高于正常组 (P <0 .0 5 ) ,而多发性骨髓瘤和骨髓增生异常综合症患者治疗前血清TGF α水平低于正常组 (P >0 .0 5 ) ,急、慢性白血病、非何杰金氏淋巴瘤和多发性骨髓瘤治疗缓解后比治疗前明显降低 (P <0 .0 1) ,骨髓增生异常综合症患者血清TGF α水平治疗后比治疗前降低但差异不显著 (P >0 .0 5 )。急、慢性白血病患者恶化后血清TNF和TGF α水平均升至治疗前水平。结论 检测血液肿瘤性疾病患者血清TNF和TGF α水平 ,有助于了解这种病人的病情变化及其预后。

ObjectiveTo study alterations in the serum levels and the clinical significance of TNF and TGF-α in patients with hematological malignancy.MethodsSerum levels of TNF and TGF-α were measured by immunoassay in 30 normal persons as controls and in 63 pateints with hematological malignancy before and after treatment and during deteriorating period of the disease.ResultsThe serum levels of TNF in patietns with hematological malignancy before treatment were much higher than those in normal controls (P<0.01).Of the same group patients the serum levels of TNF after treatment were much lower than those before treatment (P<0.01).Compared with those in normal controls,the pretreatment levels of TGF-α were significantly higher in patients with acute leukemia (AL),chronic myelogenous leukemia(CML) and non-Hodgkin lymphoma(NHL)(P<0.05) and insignificantly lower in patients with multiple and myelodysplastic syndrome (MDS)(P>0.05).In contrast to the pretreatment ones there was a sharp post-treatment decline in serum levels of TGF-α in patients with AL?CML?NHL and MM(P<0.01).But the difference between the pre- and post-treatment levels of TGF-α in MDS was insignificant (P>0.05).In patients with AL and CML both TNF and TGF-α rose to the pretreatment levels with the deterioration of the disease.ConclusionDynamic changes in serum TNF and TGF-α levels can be used as an indicator of therapeutic effect as well as prognosis.