Chen Wen-Ting, Yao Hong-Xia, Wu Cong-Ming, Fu Xiang-Jun, Huang Zhao-Qian
Department of Hematology, Hainan General Hospital,Haikou 570311, Hainan Province, China,E-mail:
Department of Hematology, Hainan General Hospital,Haikou 570311, Hainan Province, China.
Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2020 Feb;28(1):130-135. doi: 10.19746/j.cnki.issn.1009-2137.2020.01.022.
To study the expression level of TGFβ1 and VEGF gene in patients with acute myeloid leukemia (AML) and its clinical prognostic value.
Seventy-eight AML patients treated in our hospital from July 2016 to September 2018 were selected. After isolation of bone marrow mononuclear cells from the patients, the levels of TGFβ1 and VEGF genes were detected by RT-PCR, and the correlation of TGFβ1 with VEGF genes and clinical characteristics of AML patients was analyzed. OS and EFS of the patients were evaluated by Kaplan-Meier, and Cox risk ratio model was used to analyze the prognostic risk factors of AML patients.
The relative expression level of TGFβ1 gene in AML patients was 0.32±0.04, which was significantly lower than that in control group (P<005). The relative expression level of vascular endothelial growth factor(VEGF) gene in the patients was 2.65±0.15, which was significantly higher than that in the control group (P<0.05). The levels of TGFβ1 and VEGF genes significantly correlated with leukocyte count, hemoglobin, platelet and peripheral blast levels in AML patients (P<0.05). The level of TGFβ1 in AML patients with complete remission was higher than that in patients with partial remission or non-remission (P<0.05). The level of TGFβ1 in AML patients with partial remission was significantly higher than that in patients with non-remission (P<0.05). The level of VEGF in AML patients with complete remission was lower than at in patients with partial remission or non-remission (P<0.05). The level of VEGF in AML patients with partial remission was significantly lower than that in patients with non-remission (P<0.05). Kaplan-Meier survival analysis showed that OS and DFS in AML patients with high expression of TGFβ1 were better than those in patients with low expression of TGFβ1 (P<0.05), OS and DFS in AML patients with low expression of VEGF were better than those in patients with high expression of VEGF (P<0.05). Multivariate Cox regression analysis showed that platelet, TGFβ1 and VEGF gene were independent influencing factors of OS (P<0.05). Leukocyte, TGFβ1 and VEGF gene were independent influencing factors of DFS (P<0.05).
Decreased expression of TGFβ1 and increased expression of VEGF gene in AML patients closely relate to the poor prognosis of AML patients, which can provide reference for improving clinical efficacy of AML patients.
研究转化生长因子β1（TGFβ1）和血管内皮生长因子（VEGF）基因在急性髓系白血病（AML）患者中的表达水平及其临床预后价值。
选取2016年7月至2018年9月在我院治疗的78例AML患者。分离患者骨髓单个核细胞后，采用逆转录聚合酶链反应（RT-PCR）检测TGFβ1和VEGF基因水平，并分析TGFβ1与VEGF基因及AML患者临床特征的相关性。采用Kaplan-Meier法评估患者的总生存期（OS）和无事件生存期（EFS），并使用Cox风险比模型分析AML患者的预后危险因素。
AML患者TGFβ1基因相对表达水平为0.32±0.04，显著低于对照组（P<0.05）。患者血管内皮生长因子（VEGF）基因相对表达水平为2.65±0.15，显著高于对照组（P<0.05）。TGFβ1和VEGF基因水平与AML患者的白细胞计数、血红蛋白、血小板及外周血原始细胞水平显著相关（P<0.05）。完全缓解的AML患者TGFβ1水平高于部分缓解或未缓解患者（P<0.05）。部分缓解的AML患者TGFβ1水平显著高于未缓解患者（P<0.05）。完全缓解的AML患者VEGF水平低于部分缓解或未缓解患者（P<0.05）。部分缓解的AML患者VEGF水平显著低于未缓解患者（P<0.05）。Kaplan-Meier生存分析显示，TGFβ1高表达AML患者的OS和DFS优于TGFβ1低表达患者（P<0.05），VEGF低表达AML患者的OS和DFS优于VEGF高表达患者（P<0.05）。多因素Cox回归分析显示，血小板、TGFβ1和VEGF基因是OS的独立影响因素（P<0.05）。白细胞、TGFβ1和VEGF基因是DFS的独立影响因素（P<0.05）。
AML患者TGFβ1表达降低和VEGF基因表达增加与AML患者预后不良密切相关，可为提高AML患者临床疗效提供参考。
