VEGF在多发性骨髓瘤患者中的表达及其与浆膜腔积液的关系

Correlation of VEGF Expression with Serous Effusion in Multiple Myeloma Patients

目的:探讨多发性骨髓瘤患者血清中血管内皮生长因子(VEGF)的表达水平及其可能的临床意义。方法:收集2019年7月至2020年6月蚌埠医学院第一附属医院收治的68例多发性骨髓瘤患者,使用VEGF酶联免疫吸附试剂测定VEGF的表达水平,探讨其表达水平与浆膜腔积液的关系,并分析VEGF表达水平与多发性骨髓瘤患者临床特征及预后的关系。结果:68例多发性骨髓瘤患者中VEGF阳性率为36.76%(25/68);17例浆膜腔积液阳性患者中有10例(58.82%,10/17)患者VEGF阳性。浆膜腔积液阳性患者VEGF表达水平显著高于浆膜腔积液阴性患者(P<0.05);VEGF在多发性骨髓瘤患者初诊未治组表达水平明显高于治疗后缓解组(P<0.05),而与难治/复发多发性骨髓瘤患者VEGF表达水平之间差异无统计学意义(P>0.05)。68例多发性骨髓瘤患者中有48例进行了FISH检查,28例核型正常(58.33%),20例出现异常核型(41.67%),异常核型以IgH重排为主,共10例(20.83%),其他1q21+、del(13q14)、del(17p13)分别为3例(6.25%)、2例(4.17%)、7例(14.58%)。与VEGF-组比较,VEGF+组IgH重排及del(17p13)发生率较高[IgH重排:35%vs 10.71%,P=0.043;del(17p13):30%vs 3.57%,P=0.011]。与浆膜腔积液阴性组比较,浆膜腔积液阳性组del(17p13)发生率较高(31.25%vs 6.25%,P=0.021)。VEGF与浆膜腔积液均阳性者占比为14.71%(10/68),均阴性者占比为52.94%(36/68),浆膜腔积液与VEGF表达有相关性(r=0.264,P=0.029)。结论:合并浆膜腔积液的多发性骨髓瘤患者预后不良,这部分患者血清中VEGF显著高表达,升高的VEGF可能参与浆膜腔积液的发生和发展。

Objective:To investigate the expression level of vascular endothelial growth factor(VEGF)in serum of patients with multiple myeloma(MM)and its possible clinical significance.Methods:68 patients with MM who were admitted to The First Affiliated Hospital of Bengbu Medical College from July 2019 to June 2020 were collected.The expression level of VEGF was detected by VEGF enzyme-linked immunosorbent assay,the correlation of VEGF expression with serous effusion in MM was explored,and the relationship between VEGF expression level and clinical features and prognosis of patients with MM was analyzed.Results:The positive rate of VEGF was 36.76%(25/68)in 68 patients with MM,10 cases(58.82%,10/17)were VEGF positive in 17 MM patients with serous effusion.The expression level of VEGF in patients with positive serous effusion was significantly higher than that in patients with negative serous effusion(P<0.05);the expression level of VEGF in MM patients of the newly diagnosed and untreated group was significantly higher than that in the remission group after treatment(P<0.05),but there was no significant difference in the expression level of VEGF between the newly diagnosed group and the refractory/relapsed(R/R)group(P>0.05).Among 68 patients with MM,48 patients underwent FISH examination,28 cases had normal karyotype(58.33%),and 20 cases had abnormal karyotype(41.67%).The abnormal karyotype was mainly IgH rearrangement,with a total of 10 cases(20.83%);other cases:1q21+,del(13q14),del(17p13)were 3 cases(6.25%),2 cases(4.17%),7 cases(14.58%),respectively.Compared with VEGF-group,the incidence of IgH rearrangement and del(17p13)in VEGF+group was higher[IgH rearrangement:35%vs 10.71%,P=0.043;del(17p13):30%vs 3.57%,P=0.011].Compared with negative serous effusion group,the incidence of del(17p13)in positive serous effusion group was higher(31.25%vs 6.25%,P=0.021).The proportion of patients with positive VEGF and serous effusion was 14.71%(10/68),and the proportion of patients with negative VEGF and negative serous effusion was 52.94%(36/68).There was a correlation between serous effusion and VEGF expression(r=0.264,P=0.029).Conclusion:The prognosis of MM patients with serous effusion is poor,and the expression of VEGF in serum of these patients is significantly high.The increased VEGF may be involved in the occurrence and development of serous effusion.