血清VEGF、TGFβ1及...病患者中的表达及相关性分析_黄远颖.pdf

CHINA MEDICINE AND PHARMACY Vol.13 No.2 January 2023148 2023年1月第13卷第2期临床医学血液病血清VEGF、TGF1及PDCD4在慢性粒细胞白血病患者中的表达及相关性分析黄远颖1杨秋敏2司徒健瑜1张湘兰11.广东省阳江市人民医院血液内科，广东阳江529500；2.广东省阳江市人民医院肝胆胰外科，广东阳江529500 摘要 目的 探讨血清血管内皮生长因子（VEGF）、转化生长因子 1（TGF1）及程序性细胞死亡因子 4（PDCD4）在慢性粒细胞白血病（CML）患者中的表达及相关性。方法 回顾性分析 2014 年 5 月至 2017 年5 月阳江市人民医院收治的 63 例 CML 患者（作为研究组）的临床资料，另选同期于阳江市人民医院体检的健康者 30 例作为对照组。比较研究组与对照组入院 24 h 内血清 VEGF、TGF1 及 PDCD4 水平，分析CML 患者血清 VEGF、TGF1 及 PDCD4 水平与临床病理指标的关系，比较死亡组与存活组 CML 患者血清VEGF、TGF1 及 PDCD4 水平，分析 CML 患者预后影响因素以及 CML 患者无病生存期（DFS）。结果 研究组患者血清 VEGF 水平明显高于对照组，而血清 TGF1、PDCD4 水平均明显低于对照组，差异有统计学意义（P 0.05）。有无髓外浸润、不同疾病分期与危险度分型的 CML 患者血清 VEGF、TGF1 及 PDCD4水平比较，差异有统计学意义（P 0.05）。死亡组患者血清 VEGF 水平明显高于存活组，而血清 TGF1、PDCD4 水平均明显低于存活组，差异有统计学意义（P 168.72 pg/ml、TGF1 30.45 g/L、PDCD4 0.57 ng/ml 均为 CML 患者预后病死的独立危险因素（均 P 168.72 pg/ml 的患者，差异有统计学意义（P 30.45 g/L 的 CML 患者 DFS 明显大于 TGF1 30.45 g/L 的CML 患者，差异有统计学意义（P 0.57 ng/ml 的 CML 患者 DFS 明显大于 PDCD4 0.57 ng/ml患者，差异有统计学意义（P 168.72 pg/ml、TGF1 30.45 g/L、PDCD4 0.57 ng/ml 均为 CML 患者预后病死的独立危险因素，且血清 VEGF 168.72 pg/ml、TGF130.45 g/L、PDCD40.57 ng/ml 的 CML 患者整体生存情况较好。关键词 血管内皮生长因子；转化生长因子 1；程序性细胞死亡因子 4；慢性粒细胞白血病；表达 中图分类号 R733.72 文献标识码 A 文章编号 2095-0616（2023）02-0148-05Analysis on the expression and correlation of serum VEGF,TGF1 and PDCD4 in patients with chronic myeloid leukemiaHUANGYuanying1YANGQiumin2SITUJianyu1ZHANGXianglan11.Department of Hematology,People s Hospital of Yangjiang,Guangdong,Yangjiang 529500,China;2.Department of Hepatobiliary and Pancreatic Surgery,People s Hospital of Yangjiang,Guangdong,Yangjiang 529500,ChinaAbstract Objective To investigate the expression and correlation of serum vascular endothelial growth factor(VEGF),transforming growth factor 1(TGF1)and programmed cell death factor 4(PDCD4)in patients with chronic myeloid leukemia(CML).Methods The clinical data of CML patients admitted to and treated in the People s Hospital of Yangjiang from May 2014 to May 2017 were retrospectively analyzed,and the patients were set as the study group(n=63).At the same time,healthy people who had undergone physical examination in the People s Hospital of Yangjiang were selected and set as the control group(n=30).Serum levels of VEGF,TGF1 and PDCD4 were compared between the study group and the control group within 24 hours after admission.The correlation between serum levels of VEGF,TGF1 and PDCD4 and clinicopathological indices of CML patients was analyzed.Serum levels of VEGF,TGF1 and PDCD4 were compared between the death group and the survival group of CML patients,and the impacting factors of prognosis and disease-free survival(DFS)of CML patients were analyzed.Results The serum levels of VEGF in patients of the study group were significantly higher than those in the control group,while the serum levels of TGF1 and PDCD4 were all significantly lower than those in the control group,with statistically significant differences(P 0.05).Whether there was extramedullary infiltration and the serum levels of VEGF,TGF1 and PDCD4 of CML patients in CHINA MEDICINE AND PHARMACY Vol.13 No.2 January 2023149 2023年1月第13卷第2期临床医学血液病different disease stages and risk classifications were all significantly different,with statistically significant differences(P 0.05).Serum levels of VEGF in patients of the death group were significantly higher than those in the survival group,while serum levels of TGF1 and PDCD4 were all significantly lower than those in the survival group,with statistically significant differences(P 168.72pg/ml,TGF1 30.45 g/L and PDCD4 0.57 ng/ml were all independent risk factors for the prognosis of CML patients(all P 168.72 pg/ml,with statistically significant difference(P 30.45 g/L was significantly higher than that of CML patients with serum TGF1 30.45 g/L,with statistically significant difference(P 0.57 ng/ml was significantly higher than that of CML patients with PDCD4 0.57 ng/ml,with statistically significant difference(P 168.72 pg/ml,TGF1 30.45 g/L and PDCD4 0.57 ng/ml are independent risk factors for the prognosis and death of CML patients.Furthermore,CML patients with serum VEGF 168.72 pg/ml,TGF1 30.45 g/L and PDCD4 0.57 ng/ml have a better overall survival.Key words Vascular endothelial growth factor;Transforming growth factor 1;Programmed cell death factor 4;Chronic myeloid leukemia;Expression慢性粒细胞白血病（chronic myeloid leukemia，CML）是一种起源于多能造血干细胞的恶性骨髓增生性血液疾病，约占成年人白血病病例总数的20%1。根据 CML 疾病分期可将其分为慢性期、加速期以及急变期三种，其中慢性期 CML 患者病情进展较为缓慢，通常病程较长（可持续数年），且通过使用酪氨酸激酶抑制剂治疗可有效延长患者总生存期，而加速期以及急变期 CML 患者病情进展较为迅速，病程较短且普遍预后较差2。因此，实现对 CML 病情进展的准确评估，对于 CML 的治疗及预后改善均具有重要的临床价值3。近年来，血清学指标因具有检测快捷、方便等优点，常作为对 CML 患者疾病进展监测及预后评估的重要指标4。已有研究表明 CML 患者血清血管内皮生长因子（vascular endothelial growth factor，VEGF）、转化 生 长 因 子 1（transforming growth factor 1，TGF1）及程序性细胞死亡因子 4（programmed cell death factor 4，PDCD4）水平均呈异常表达，且表达水平与 CML 患者病情进展关系密切5-6，但血清 VEGF、TGF1 及 PDCD4 水平检测用于评估CML 患者预后的相关报道却较为少见。鉴于此，本研究回顾性分析 2014 年 5 月至 2017 年 5 月阳江市人民医院（我院）收治的 63 例 CML 患者的临床资料，对血清 VEGF、TGF1 及 PDCD4 在 CML 患者中的表达及相关性进行探讨，现报道如下。1资料与方法1.1一般资料本研究已通过我院医学伦理委员会批准。回顾性分析 2014 年