多发性骨髓瘤患者骨髓微龛中CXCL12、CXCR4、VEGF、MVD的表达及与预后的相关性研究

Correlation between Expression of CXCL12,CXCR4,VEGF,MVD and Prognosis in Patients with Multiple Myeloma

目的:研究多发性骨髓瘤(MM)患者骨髓微龛中基质细胞衍生因子(CXCL12)、基质细胞衍生因子受体(CXCR4)、血管内皮细胞生长因子(VEGF)、微血管密度(MVD)的表达情况及与预后相关性。方法:免疫组化法检测57例初诊MM患者骨髓标本及26例正常骨髓标本骨髓微龛CXCL12、CXCR4、VEGF、MVD的表达情况,并使用秩和检验比较2组指标的差异;收集患者临床资料,分析MM组指标与预后的相关性。结果:MM组患者骨髓活检组织中CXCL12、CXCR4、VEGF、MVD表达水平较正常对照组骨髓活检组织明显增高(P<0.05)。MM组骨髓中CXCL12、CXCR4、VEGF、MVD表达水平与患者ISS分期、危险分层、骨髓中浆细胞比例相关(P<0.05)。单因素分析57例MM患者资料发现,年龄、ISS分期、危险分层、浆细胞比例、CXCL12、CXCR4、VEGF、MVD表达与患者预后相关(P<0.05)。多因素分析发现,CXCR4、VEGF、MVD表达水平、年龄、浆细胞比例是独立预后因素。结论:CXCL12、CXCR4、VEGF、MVD在MM患者骨髓中表达增高,4者的表达与MM发生、发展相关,其高表达可能提示患者预后不良。

Objective:To investigate the expressions of stromal cell-derived factor(CXCL12),stromal cell-derived factor receptor(CXCR4),vascular endothelial growth factor(VEGF)and microvessel density(MVD)in bone marrow microsputum of patients with multiple myeloma(MM)and their correlation with the prognosis.Methods:The expressions of CXCL12,CXCR4,VEGF and MVD in bone marrow microtubules of 57 newly diagnosed MM patients and 26 normal bone marrow samples were detected by immunohistochemistry.The rank sum test was used to compare the differences between the two groups.The clinical data of the patients were collected to analyze the correlation between the indicators of the MM group and the prognosis.Results:The expressions of CXCL12,CXCR4,VEGF and MVD in the bone marrow biopsy of the patients in MM group were significantly higher than those in the normal control group(P<0.05).The expressions levels of CXCL12,CXCR4,VEGF and MVD were in the bone marrow of the patients in MM group were correlated with the ISS stage,risk stratification and the proportion of plasma cells in the bone marrow(P<0.05).Univariate analysis showed that age,ISS stage,risk stratification,plasma cell ratio,expressions of CXCL12,CXCR4,VEGF,and MVD associated with the prognosis of patients with MM(P<0.05).Multivariate analysis found that expressions of CXCR4,VEGF,MVD,age,and plasma cell ratio were independent prognostic factors.Conclusion:The expressions of CXCL12,CXCR4,VEGF and MVD are increase in the bone marrow of patients with multiple myeloma,and their expressions levels are associate with the occurrence and development of multiple myeloma,and their high expression may indicate a poor prognosis.