Wróbel T, Poreba M, Mazur G, Poreba R, Pyszel A, Beck B, Steinmetz-Beck A, Andrzejak R, Kuliczkowski K
Department of Hematology, Blood Neoplasms and Bone Marrow Transplantation, Wroclaw Medical University, 50-367 Wroclaw, Poland.
Neoplasma. 2006;53(3):253-8.
High serum VEGF and bFGF levels are independent prognostic factors of poor prognosis in NHL patients. There is growing evidence that both angiogenesis and haemostatic aberrancies are integral parts of the pathobiology of cancer growth and dissemination. The purpose of the study was: (a) to analyze relations of VEGF and bFGF serum levels, fibrinogen and D-dimer plasma levels with lymphoma Ann Arbor Staging System (AASS) and International Prognostic Index (IPI) and, (b) to evaluate correlations between serum levels of angiogenic cytokines and plasma levels of coagulation-fibrinolysis factors in 52 previously untreated NHL patients included to the study. The control group consisted of 23 healthy volunteers. Serum VEGF, bFGF and plasma D-dimer levels were measured by enzyme-linked immunosorbent assay (ELISA). Plasma levels of fibrinogen were determined on Behring Coagulation System (BCS) equipment. In lymphoma group serum VEGF and bFGF levels were significantly higher than in the control. Differences in concentrations of VEGF, bFGF between II, III and IV stage of disease acc. AASS were not statistically significant. Plasma levels of fibrinogen and D-dimer were elevated in lymphoma patients when compared with the control. Fibrinogen plasma levels were similar in all stages. The D-dimer level was significantly higher in patients with IV stage in comparison to stage II and III. Statistically significant differences of VEGF and bFGF serum levels were observed only between intermediate/high and high risk groups acc. IPI. Fibrinogen plasma levels were significantly higher in high risk group than in low risk group. D-dimer plasma levels were significantly higher in high risk group than in low risk group and low/intermediate group. We observed positive correlation between serum level of VEGF and plasma level of fibrinogen, and between serum level of bFGF and plasma level of fibrinogen. There was also negative correlation between serum level of VEGF and plasma level of D-dimer, and between serum level of bFGF and plasma level of D- dimer. Our study indicates that D-dimer level, but not VEGF, bFGF and fibrinogen correlates with AASS and IPI in NHL patients. Significant correlations between levels of VEGF/bFGF and fibrinogen/D-dimer suggest specific interactions between angiogenic and coagulation-fibrinolysis system.
血清VEGF和bFGF水平升高是NHL患者预后不良的独立预后因素。越来越多的证据表明，血管生成和止血异常都是癌症生长和扩散病理生物学的重要组成部分。本研究的目的是：（a）分析VEGF和bFGF血清水平、纤维蛋白原和D-二聚体血浆水平与淋巴瘤Ann Arbor分期系统（AASS）和国际预后指数（IPI）的关系，以及（b）评估52例纳入本研究的未经治疗的NHL患者血清血管生成细胞因子水平与凝血-纤溶因子血浆水平之间的相关性。对照组由23名健康志愿者组成。采用酶联免疫吸附测定（ELISA）法检测血清VEGF、bFGF和血浆D-二聚体水平。在贝林凝血系统（BCS）设备上测定纤维蛋白原的血浆水平。淋巴瘤组血清VEGF和bFGF水平显著高于对照组。根据AASS，疾病II、III和IV期VEGF、bFGF浓度差异无统计学意义。与对照组相比，淋巴瘤患者血浆纤维蛋白原和D-二聚体水平升高。各阶段纤维蛋白原血浆水平相似。IV期患者的D-二聚体水平显著高于II期和III期。根据IPI，仅在中/高风险组和高风险组之间观察到VEGF和bFGF血清水平的统计学显著差异。高风险组纤维蛋白原血浆水平显著高于低风险组。高风险组D-二聚体血浆水平显著高于低风险组和低/中风险组。我们观察到血清VEGF水平与血浆纤维蛋白原水平之间以及血清bFGF水平与血浆纤维蛋白原水平之间呈正相关。血清VEGF水平与血浆D-二聚体水平之间以及血清bFGF水平与血浆D-二聚体水平之间也呈负相关。我们的研究表明，在NHL患者中，D-二聚体水平而非VEGF、bFGF和纤维蛋白原与AASS和IPI相关。VEGF/bFGF水平与纤维蛋白原/D-二聚体水平之间的显著相关性表明血管生成和凝血-纤溶系统之间存在特定的相互作用。
