摘要
目的检测不同分期慢性粒细胞白血病(chronic myeloid leukemia,CML)患者不同发展阶段血清环氧合酶-2(cyclooxygenase-2,COX-2)、碱性成纤维细胞生长因子(basic fibroblast growth factor,b FGF)及转化生长因子(transforminggrowth factor-β1,TGF-β1)的变化,并探讨其在CML的诊治和预后中的临床意义。方法 50例初诊患者[慢性期(chronic phase,CP)30例,加速期(accelerated phase,AP)10例,急变期(blast crisis,BC)10例]为CML组,健康体检者40例为正常对照,采用ELISA方法检测血清COX-2、b FGF及TGF-β1水平。结果初诊时,与对照组相比,CML组患者的血清COX-2及b FGF含量升高,而TGF-β1含量减低(P<0.001)。CML组急变期、加速期患者血清b FGF及COX-2水平较慢性期患者增高,而TGF-β1水平减低(P<0.001)。完全缓解(complete response,CR)时,CML患者血清b FGF及COX-2含量下降,而TGF-β1含量基本恢复到正常水平,与正常对照组比较,差异无统计学意义(P>0.05);未达到缓解时,血清b FGF、COX-2及TGF-β1水平与CR组比较,差异有统计学意义(P<0.001)。CML初诊患者治疗前血清b FGF、VEGF水平与TGF-β1呈负相关(P<0.05)。结论 CML患者初诊时COX-2及b FGF高表达,TGF-β1低表达,治疗后,达到CR时,血清相关因子水平基本恢复正常,提示其与CML的发生、发展与血管生成有密切关系。因此,动态监测CML患者血清COX-2、b FGF及TGF-β1水平,可作为CML病情评估的重要参考指标。
Objective To measure the serum levels of COX-2, b FGF, TGF-β1 in patients at different stages of chronicmyeloid leukemia,and we study the clinical significance of diagnosis, treatment and prognosis of the disease. Methods Theserum levels of COX-2, b FGF, TGF-β1 in 50 chronic myeloid leukemia patients[chronic phase（CP） 30 cases, accelerationperiod（AP） 10 cases, blast crisis period（BC） 10 cases], and 40 healthy adults as control were determined by ELISA, and theresults were analyzed at different stages of the disease. Results Compared with the normal control group,the plasma levelsof b FGF and COX-2 were found to be elevated, and TGF-β1 decreased before treatment in the chronic myeloid patients（P〈0.001）. Compared with the chronic phase group, the plasma levels of b FGF and COX-2 were elevated, and TGF-β1 decreasedin accelerated phase group and blast crisis group（P〈0.001）. Also, when the chronic phase group was compared,differenceswere again found in the levels of COX-2, b FGF and TGF-β1（P〈0.001）. Compared with the normal control group,nodifferences were found in the serum levels of COX-2, b FGF and TGF-β1 in the patients with chronic myeloid leukemia aftercomplete remission（CR）. Compared with the no remission group,differences were found in the serum levels of COX-2, b FGFand TGF-β1 in the patients with chronic myeloid leukemia after complete remission（CR）（P〈0.001）. Finally, a negativecorrelation was found in the serum levels of COX-2, b FGF and TGF-β1 in the patients with chronic myeloid leukemia（P〈0.05）. Conclusion Serum levels of COX-2 and b FGF elevated, TGF-β1 decreased before treatment in acute leukemiapatients, but after complete remission, the serum levels of these angiogenic factors were found to be normal. Angiogenesis mayplay a role in the leukemogenic process. Therefore, monitoring the levels of serum COX-2, b FGF and TGF-β1 at differentstages of acute leukemia can provide clinical evidence of disease progression.
出处
《中国热带医学》
CAS
2017年第4期393-396,407,共5页
China Tropical Medicine
基金
陕西省卫生科研项目(No.D80)
