【摘要】 目的:评估检测血清IL-17在多发性骨髓瘤(MM)诊断、预后及疗效判断方面的应用价值。方法:ELISA法检测21例MM患者(初诊7例,复发9例,平稳期5例)和15名健康体检者的IL-17、VEGF、TNF-α和β2-m血清含量,并分析IL-17与VEGF、TNF-α和β2-m水平之间的相关性。结果:初诊及复发MM患者的IL-17、VEGF、TNF-α和β2-m水平显著高于平稳期MM患者和对照组,差异有统计学意义,P<0.05。平稳期MM患者与对照组之间差异无统计学意义,P>0.05。IL-17、VEGF、TNF-α和β2-m的血清水平随着临床分期的增加而呈增高趋势,且除了IL-17外,Ⅲ期MM患者的VEGF、TNF-α和β2-m的血清水平均显著高于Ⅱ期患者,Ⅱ期患者显著高于Ⅰ期患者,差异均有统计学意义,P<0.05;ⅢA期MM患者的IL-17水平虽高于ⅡB期MM患者,但差异无统计学意义,P>0.05。比较各期患者A和B亚型各因子水平差异发现,除β2-m外,其余因子水平均是B亚型显著高于A亚型,差异有统计学意义(P<0.05),而ⅢB期MM患者的β2-m水平虽高于ⅢA期MM患者,但差异无统计学意义,P>0.05。MM患者的IL-17水平与TNF-α(r=0.918)、VEGF(r=0.862)和β2-m(r=0.953)均呈正相关,P值均<0.01。结论:IL-17能够促进血管新生并与MM进展相关,可作为MM临床分期、预后及疗效判断的潜在指标。更多还原

【Abstract】 OBJECTIVE:To assess the diagnosis,prognosis and therapeutic evaluation of determination of serum levels of IL-17 in patients with multiple myeloma(MM).METHODS:Serum levels of IL-17,VEGF,TNF-α,and β2-m were measured in 7 patients with primary MM,9 patients with relapse MM,5 patients with remission MM and 15 controls with ELISA,and the correlation of IL-17 and VEGF,TNF-α,β2-m was detected.RESULTS: The levels of IL-17,VEGF,TNF-α,and β2-m in the sera of patients with primary MM and patients with relapse MM were significantly higher than those in patients with remission MM and controls(P<0.05).However the difference between patients with remission MM and controls did not reach statistical significance(P>0.05).The serum levels of IL-17,VEGF,TNF-α and β2-MG increased from stage Ⅰ to stage Ⅲ,and the difference in the consecutive stages reached statistical significance(P<0.05).The serum levels of IL-17 in patients with MM stage ⅢA were higher than those in patients with MM stage ⅡB,the difference in two stages did not reach statistical significance(P>0.05).Detailed analysis revealed that these cytokine levels in patients with MM group B were significantly higher than those in group A(P<0.05),except β2-MG.The levels of others between stage ⅢA and stage ⅢB did not reach statistical significance(P>0.05).Serum values of IL-17 in MM patients correlated positively not only with TNF-α(r=0.918) and VEGF(r=0.862),but also with β2-m(r=0.953) P values less than 0.01.CONCLUSIONS:These results suggest that IL-17 plays a role in the promotion of angiogenesis and is associated with disease progression in MM.It may be a potential marker for determination of clinical stage,prognosis and efficacy in MM patients.更多还原