Study on relationship between VEGF, TGF-β1 and risk level in patients with recurrent acute myeloid leukemia
-
摘要: 目的观察血管内皮生长因子(VEGF)、转化生长因子-β1(TGF-β1)在复发性急性髓系白血病(AML)患者不同危险层级中的表达，并分析VEGF、TGF-β1与不同危险层级的关系。方法纳入2019年10月至2021年10月收治的92例复发性AML患者进行研究，根据相关指南对92例患者进行预后危险层级评估；在评估前对患者进行相关检查和资料收集，检查项目包括血小板计数(PLT)、白细胞计数(WBC)、中性粒细胞计数(NE)、血红蛋白(Hb)和VEGF、TGF-β1等，观察各指标在不同危险层级患者中的表达，采用Kendall's tau-b相关系数，分析VEGF、TGF-β1与复发性AML不同危险层级的关系。结果92例复发性AML患者，经评估后分为低危患者32例，中危患者40例，高危患者20例，不同危险层级患者一般资料比较，差异无统计学意义。不同危险层级患者PLT、WBC、NE、Hb、VEGF、TGF-β1比较，差异有统计学意义(P＜0.05)；但PLT、WBC、NE、Hb在低危和中危，中危和高危患者之间比较，差异无统计学意义；在低危和高危之间相比较，差异有统计学意义(P＜0.05)。采用Kendall's tau-b相关系数检验，VEGF与复发性AML患者危险层级呈正相关(r＞0，P＜0.05)；TGF-β1与复发性AML患者危险层级呈负相关(r < 0，P＜0.05)。结论血清VEGF、TGF-β1表达在复发性AML患者不同危险层级中差异有统计学意义，其中VEGF与复发性AML患者危险层级呈正相关，TGF-β1与复发性AML患者危险层级呈负相关。
-
关键词:
- 复发性急性髓系白血病 /
- 危险层级 /
- 血管内皮生长因子 /
- 转化生长因子-β1
Abstract: ObjectiveTo observe the expression of vascular endothelial growth factor(VEGF) and transforming growth factor β1(TGF-β1) in different risk levels of patients with recurrent acute myeloid leukemia(AML), and analyze the relationship between VEGF, TGF-β1 and different risk levels.MethodsA total of 92 patients with recurrent AML admitted to the hospital from October 2019 to October 2021 were included in the study, and the prognosis risk level of 92 patients was evaluated according to relevant guidelines; relevant examinations and general data collection were conducted for the patients before the assessment. The examination items included platelet(PLT), white blood cell count(WBC), neutrophil count(NE), hemoglobin(Hb), VEGF, TGF-β1, etc. Observed the expression of each index in patients with different risk levels, and analyzed the relationship between VEGF, TGF-β1 and different risk levels of recurrent AML by Kendall's tau-b correlation coefficient.ResultsAfter evaluation, 92 patients with recurrent AML were identified as 32 low-risk patients, 40 moderate risk patients and 20 high-risk patients. There was no statistical significant difference in comparison of the general data of patients at different risk levels. Compared PLT, WBC, NE, GHB, VEGF and TGF-β1 among patients at different risk levels, the difference was statistically significant(P < 0.05). However, there was no statistical significant difference in comparison of PLT, WBC, NE and Hb between low-risk and moderate risk patients, and between moderate and high-risk patients; compared between low risk and high risk, the difference was statistically significant(P < 0.05). By Kendall's tau-b correlation coefficient test, VEGF was positively correlated with the risk level of patients with recurrent AML(r > 0, P < 0.05); TGF-β1 was negatively correlated with the risk level of recurrent AML(r < 0, P < 0.05).ConclusionThe expressions of serum VEGF and TGF-β1 were significantly different in different risk levels of the patients with recurrent AML. VEGF was positively correlated with the risk level of the patients with recurrent AML, and TGF-β1 was negatively correlated with the risk level of the patients with recurrent AML. -
-
表 1 复发AML预后危险层级评估
评估指标 0分 1分 2分 3分 5分 缓解至复发时间/月 ＞18 / / 7~18 ≤6 初发时细胞遗传学 inv(16)或t(16；16) / / t(8；21) 其他 造血干细胞移植 否 / 是 / / 复发时年龄/岁 ≤35 36~45 ＞45 / / 
下载: 导出CSV
表 2 不同危险层级患者一般资料比较
一般资料 低危(32例) 中危(40例) 高危(20例) χ2/H/F P 性别/例(%) 2.172 0.338 男 14(43.75) 20(50.00) 6(30.00) 女 18(56.25) 20(50.00) 14(70.00) 年龄/岁 35.00(30.50，38.00) 35.00(31.00，39.00) 35.00(30.50，41.00) 0.476 0.788 BMI/(kg·m-2) 21.72±0.66 21.62±0.68 21.78±0.72 0.416 0.661 MDS病史/例(%) 4.284 0.117 有 11(34.37) 22(55.00) 12(60.00) 无 21(65.63) 18(45.00) 8(40.00) FAB分型/例(%) 5.412 0.428 M0 10(31.25) 15(37.50) 8(40.00) M1 14(43.75) 18(36.00) 4(20.00) M2 8(25.00) 7(17.50) 8(40.00)
下载: 导出CSV
表 3 不同危险层级患者检查指标比较
X±S 检测指标 低危(32例) 中危(40例) 高危(20例) F P PLT/(×109·L-1) 90.24±8.55 86.52±8.26 84.45±8.06 3.353 0.039 WBC/(×109·L-1) 16.45±1.62 17.16±1.83 17.85±2.05 4.142 0.019 NE/(×109·L-1) 8.62±1.06 9.15±1.24 9.42±1.32 5.313 0.007 Hb/(g·L-1) 88.45±8.26 84.45±7.58 82.26±8.06 3.792 0.026 VEGF/(pg·mL-1) 162.25±16.44 195.52±20.52 226.15±22.45 90.221 ＜0.001 TGF-β1/(pg·mL-1) 56.12±6.65 51.56±5.85 45.24±5.32 25.535 ＜0.001
下载: 导出CSV
-
[1] Bose P, Vachhani P, Cortes JE. Treatment of Relapsed/Refractory Acute Myeloid Leukemia[J]. Curr Treat Options Oncol, 2017, 18(3): 17. doi: 10.1007/s11864-017-0456-2
[2] 张文荟, 陈香丽, 陈玉清, 等. 高三尖杉酯碱联合阿扎胞苷与Venetoclax治疗难治/复发急性髓系白血病疗效观察[J]. 新乡医学院学报, 2021, 38(6): 580-584. https://www.cnki.com.cn/Article/CJFDTOTAL-XXYX202106018.htm
[3] 中华医学会血液学分会白血病淋巴瘤学组. 中国复发难治性急性髓系白血病诊疗指南(2021年版)[J]. 中华血液学杂志, 2021, 42(8): 624-627.
[4] Linhares P, Viana-Pereira M, Ferreira M, et al. Genetic variants of vascular endothelial growth factor predict risk and survival of gliomas[J]. Tumour Biol, 2018, 40(3): 1010428318766273.
[5] 吴福群, 阴常欣, 邓绍团, 等. 急性髓系白血病患者血清sPD-L1、VEGF表达及相关性[J]. 中国医药导报, 2019, 16(20): 76-79, 87.
[6] Åström P, Juurikka K, Hadler-Olsen ES, et al. The interplay of matrix metalloproteinase-8, transforming growth factor-β1 and vascular endothelial growth factor-C cooperatively contributes to the aggressiveness of oral tongue squamous cell carcinoma[J]. Br J Cancer, 2017, 117(7): 1007-1016. doi: 10.1038/bjc.2017.249
[7] 雷永兰, 牛敏, 李靖, 等. NLR联合血清β2-MG、TGF-β1对急性髓系白血病的预后分析价值[J]. 临床血液学杂志, 2021, 34(10): 728-731. http://lcxz.cbpt.cnki.net/WKC/WebPublication/paperDigest.aspx?paperID=4d168427-7c76-4efc-8a6d-23feb5c2020d
[8] Thol F, Ganser A. Treatment of Relapsed Acute Myeloid Leukemia[J]. Curr Treat Options Oncol, 2020, 21(8): 66. doi: 10.1007/s11864-020-00765-5
[9] 宗李红, 吴小霞, 张剑, 等. 维奈克拉联合阿扎胞苷治疗难治复发性急性髓系白血病疗效及安全性分析[J]. 中华血液学杂志, 2021, 42(10): 861-864. doi: 10.3760/cma.j.issn.0253-2727.2021.10.012
[10] Geindreau M, Ghiringhelli F, Bruchard M. Vascular Endothelial Growth Factor, a Key Modulator of the Anti-Tumor Immune Response[J]. Int J Mol Sci, 2021, 22(9): 4871. doi: 10.3390/ijms22094871
[11] Hisada Y, Mackman N. Tissue Factor and Cancer: Regulation, Tumor Growth, and Metastasis[J]. Semin Thromb Hemost, 2019, 45(4): 385-395. doi: 10.1055/s-0039-1687894
[12] Infante MS, Piris MÁ, Hernández-Rivas JÁ. Molecular alterations in acute myeloid leukemia and their clinical and therapeutical implications[J]. Med Clin(Barc), 2018, 151(9): 362-367.
[13] 于艳芳, 申娜, 翟志海. 血管内皮生长因子水平对急性白血病患者预后的预测作用分析[J]. 现代中西医结合杂志, 2019, 28(30): 3398-3401. https://www.cnki.com.cn/Article/CJFDTOTAL-XDJH201930027.htm
[14] Salemi M, Mohammadi S, Ghavamzadeh A, et al. Anti-Vascular Endothelial Growth Factor Targeting by Curcumin and Thalidomide in Acute Myeloid Leukemia Cells[J]. Asian Pac J Cancer Prev, 2017, 18(11): 3055-3061.
[15] 仲林, 关宏伟, 张朋新, 等. 早期肺腺癌中TGF-β1、p53、E-cadherin的表达及其相关性[J]. 临床与实验病理学杂志, 2020, 36(7): 854-856. https://www.cnki.com.cn/Article/CJFDTOTAL-LSBL202007028.htm
[16] 任丽蓉, 官晓红, 练颖, 等. 急性髓系白血病患者血清β2-MG、HGF、TGFβ1表达及临床意义[J]. 标记免疫分析与临床, 2020, 27(3): 488-492. https://www.cnki.com.cn/Article/CJFDTOTAL-BJMY202003029.htm
[17] 张江召, 刘敏, 黄知平. 基于决策曲线分析血清TGF-β1、EGFR水平对急性髓系白血病患者大剂量AraC治疗效果的影响[J]. 中国实验血液学杂志, 2022, 30(2): 407-412. https://www.cnki.com.cn/Article/CJFDTOTAL-XYSY202202014.htm
[18] 廖雪莲, 谢晓恬, 李本尚, 等. 血管内皮生长因子对人急性白血病细胞凋亡影响及相关基因表达的临床与实验研究[J]. 中国当代儿科杂志, 2006, (6): 491-495. https://www.cnki.com.cn/Article/CJFDTOTAL-DDKZ200606014.htm
[19] 王蕾, 李艳. 外源性TGF-β_1对原代急性早幼粒细胞白血病细胞凋亡的影响及机制探讨[J]. 山东医药, 2014, 54(11): 22-25. https://www.cnki.com.cn/Article/CJFDTOTAL-SDYY201411010.htm
[20] 沈璟璟, 钟璐, 陈芳源. TGF-β/Smads信号转导与白血病细胞的关系[J]. 上海交通大学学报(医学版), 2008, 49(8): 1038-1041. https://www.cnki.com.cn/Article/CJFDTOTAL-SHEY200808036.htm
-