急性髓系白血病患者血清骨桥蛋白和VEGF水平与其化疗敏感性和复发的相关性分析

来源:用户上传      作者:梁月雄 黄鹏程 李冰 司艳辉 莫淑宜 朱海峰

　　[摘要] 目的探急性髓系白血病患者血清骨桥蛋白（OPN）和血管内皮生长因子（VEGF）水平与其化疗敏感性和复发的相关性。方法选取2014年 1月至2016年 2月肇庆市第一人民医院血液科急性髓系白血病患者62例为研究对象，常规进行化疗，检测比较化疗前、化疗1 个疗程以及化疗2 个疗程的 OPN 和 VEGF 水平，并随访观察至少1 年。评价患者化疗敏感性并统计其随访期间复发率。分析其血清 OPN 和 VEGF 水平与其化疗敏感性和复发的关系以及其联合预测其复发的价值。结果与化疗前比较，患者化疗1 个疗程以及化疗2 个疗程的血清 OPN 和 VEGF 水平均降低;与化疗1 个疗程比较，患者化疗2 个疗程的血清 OPN 和 VEGF 水平均降低（ P <0.05）。患者总缓解率为69.35%，随访期间复发率为29.03%。与缓解患者比较，未缓解患者化疗前后的血清 OPN 和 VEGF 水平均更高（ P <0.05）。与无复发患者比较，复发患者化疗前后的血清 OPN 和 VEGF 水平均更高（ P <0.05）。Spearman 相关分析结果显示急性髓系白血病血清 OPN 和 VEGF 水平与其化疗缓解率呈负相关（ r=-0.782、-0.858，P <0.05），与其复发率呈正相关（ r=0.822、0.896， P <0.05）。ROC 曲线分析结果显示，急性髓系白血病化疗前后血清 OPN 和 VEGF 水平联合预测其复发的价值良好，其中以化疗2 个疗程血清 OPN 和 VEGF 水平联合预测其复发的价值最优。结论急性髓系白血病血清 OPN 和 VEGF 水平与其化疗敏感性和复发均密切相关且联合预测其复发的价值良好，可能作为其化疗敏感性和复发评估的参考指标。
　　[关键词] 急性髓系白血病;骨桥蛋白;血管内皮生长因子;化疗;敏感性;复发
　　[中图分类号] R733.71 [文献标识码] A [文章编号] 2095-0616（2022）06-0145-05
　　Analysis on the correlation of serum osteopontin and VEGF levels with chemotherapy sensitivity and relapse in patients with acute myeloid leukemia
　　LIANG Yuexiong HUANG Pengcheng LI Bing SI Yanhui MO Shuyi ZHU Haifeng
　　Department of Hematology， the First People’s Hospital of Zhaoqing， Guangdong， Zhaoqing 526000， China
　　[Abstract] Objective To investigate the correlation of serum osteopontin （OPN） and vascular endothelial growth factor （VEGF） levels with chemotherapy sensitivity and relapse in patients with acute myeloid leukemia （AML）. Methods A total of 62 patients with AML in the Department of Hematology at the First People’s Hospital of Zhaoqing from January 2014 to February 2016 were selected as study subjects. All patients underwent conventional chemotherapy， and serum OPN and VEGF levels were detected and compared before chemotherapy and at 1 course and 2 courses of chemotherapy， and were followed up and observed for at least 1 year. The chemotherapy sensitivity of patients was evaluated and the relapse rate was calculated during the follow-up period. The correlation of serum OPN and VEGF levels with chemotherapy sensitivity and relapse in patients was analyzed， and the value of the combination of serum OPN and VEGF levels in predicting relapse was also analyzed. Results Serum OPN and VEGF levels at 1 course and 2 courses of chemotherapy were lower than those before chemotherapy， and those at 2 courses of chemotherapy were lower than those at 1 course of chemotherapy （P <0.05）. The overall remission rate of patients was 69.35%， and the relapse rate during follow-up was 29.03%. Serum OPN and VEGF levels were higher before and after chemotherapy in patients with remission than those in patiens with no remission （P <0.05）. Serum OPN and VEGF levels were higher before and after chemotherapy in patients with relapse than those in patients with no relapse （P <0.05）. Spearman’s correlation analysis showed that serum OPN and VEGF levels were negatively correlated with the remission rate （r=-0.782， -0.858， P <0.05） and positively correlated with the relapse rate （r=0.822， 0.896， P <0.05） in AML patients undergoing chemotherapy. The results of receiveroperating characteristic （ROC） curve analysis showed that the combination of serum OPN and VEGF levels had good value in predicting relapse in AML patients before and after chemotherapy， with the best predictive value at 2 courses of chemotherapy. Conclusion Serum OPN and VEGF levels are closely correlated with the chemotherapy sensitivity and relapse in AML patients， and the combination of serum OPN and VEGF levels is of good value in predicting relapse， which may be used as a reference index for the assessment of chemotherapy sensitivity and relapse.

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