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弥漫大B细胞淋巴瘤治疗后血清β2-MG VEGF与LDH水平变化及其临床意义 被引量:26

Clinical significance of changes in levels of serum β2-MG, VEGF, and LDH in patients with diffuse large B-cell lymphoma after treatment
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摘要 目的:分析弥漫大B细胞淋巴瘤(diffuse large B-cell lymphoma,DLBCL)患者治疗后血清β2微球蛋白(β2 microglobulin,β2-MG)、血管内皮生长因子(vascular endothelial growth factor,VEGF)及乳酸脱氢酶(lactate dehydrogenase,LDH)水平的变化和临床意义。方法:选取2015年2月至2017年7月四川省人民医院收治的89例DLBCL患者为研究对象(DLBCL组),选择同期至四川省人民医院行体格检查的健康人群40例作为对照组,入院后所有DLBCL患者均接受标准化疗,化疗前后均留取患者外周静脉血,测定血清β2-MG、VEGF及LDH水平的变化,与对照组相比;采集所有DLBCL患者的临床病例资料,分析上述因子的变化与DLBCL患者临床病理参数和疗效的关系。结果:入院时DLBCL患者血清β2-MG、VEGF及LDH水平均高于对照组(P<0.05);化疗后DLBCL患者血清β2-MG、VEGF及LDH水平均降低,与同组化疗前比较差异具有统计学意义(P<0.05);化疗R-CHOP方案组患者的治疗有效率明显高于CHOP组(P<0.05);伴典型B症状患者血清LDH水平高于未伴B症状患者(P<0.05),Ann Arbor分期为Ⅲ~Ⅳ期患者血清β2-MG、VEGF及LDH水平均高于分期为Ⅰ~Ⅱ期患者(P<0.05),伴骨髓侵犯患者高于未伴骨髓侵犯患者(P<0.05),国际预后指数(international prognostic index,IPI)为高危的患者高于低危患者(P<0.05),治疗反应无效的患者高于有效患者(P<0.05);DLBCL患者血清VEGF、β2-MG及LDH水平表达三者互相比较均呈正相关,三者与治疗有效率的对比均呈负相关(P<0.05)。结论:DLBCL患者血清β2-MG、VEGF及LDH水平较高,且在治疗后呈明显下调,三者表达水平的变化均与患者临床分期、骨髓侵犯、IPI指数和治疗反应相关,提示其可作为DLBCL患者疾病监测、治疗疗效和预后评估的依据。 Objective:To assess the clinical significance of changes in levels of serumβ2 microglobulin(β2-MG),vascular endothelial growth factor(VEGF),and lactate dehydrogenase(LDH)in patients with diffuse large B-cell lymphoma(DLBCL)after treatment.Methods:A total of 89 patients with DLBCL who were admitted to the hospital between February 2015 an July 2017 were included in the DLBCL group and 40 normal,healthy persons admitted during the same period were selected as the control group.All DLBCL patients underwent standard chemotherapy after admission.Peripheral venous blood was collected before and after chemotherapy to determine any changes in serumβ2-MG,VEGF,and LDH levels.Biomarker levels were also compared with those from normal,healthy subjects.The clinical and pathological data of all DLBCL patients were collected and the relationships between changes in biomarker levels,clinical and pathological parameters of DLBCL,and curative effects were analyzed.Results:The levels of serumβ2-MG,VEGF,and LDH in the DLBCL group were higher than those in the control group(P<0.05)and all levels in DLBCL group decreased after chemotherapy(P<0.05).The effective rate of the R-CHOP group was higher than that of the CHOP group(P<0.05).Serum LDH levels were higher in patients with typical B symptoms than in those without such symptoms(P<0.05).Serum levels ofβ2-MG,VEGF,and LDH were higher in patients with Ann Arbor stageⅢ-Ⅳlymphoma,with bone marrow involvement,whose international prognostic index(IPI)was high-risk,and with treatment failure than in those with stageⅠ-Ⅱlymphoma,without bone marrow involvement,with low-risk IPI,and with treatment response(P<0.05).The levels of serum VEGF,β2-MG,and LDH were positively correlated with each other,and all three biomarkers were negatively correlated with treatment response(P<0.05).Conclusions:Levels of serumβ2-MG,VEGF,and LDH are elevated in patients with DLBCL but are significantly decreased after treatment.Changes in expression levels of these three biomarkers are related to clinical stage,bone marrow involvement,IPI,and treatment response.These biomarkers can be used as a basis for monitoring DLBCL and evaluating curative effect and prognosis.
作者 肖蓉 姜涛 万纯黔 李慧 李成龙 车菲菲 陈姣 黄晓兵 王春森 王晓冬 Rong Xiao;Tao Jiang;Chunqian Wan;Hui Li;Chenglong Li;Feifei Che;Jiao Chen;Xiaobing Huang;Chunsen Wang;Xiaodong Wang(Department of Hematology,Sichuan Academy of Medical Sciences&Sichuan Provincial People's Hospital,Chengdu 610072,China)
出处 《中国肿瘤临床》 CAS CSCD 北大核心 2018年第19期994-999,共6页 Chinese Journal of Clinical Oncology
关键词 弥漫大B细胞淋巴瘤 Β2-微球蛋白 血管内皮生长因子 乳酸脱氢酶 病理 diffuse large B-cell lymphoma(DLBCL) β2-microglobulin vascular endothelial growth factor(VEGF) lactate dehydrogenase(LDH) pathology
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