Objective: To study the expression level of TGFβ1 and VEGF gene in patients with acute myeloid leukemia (AML) and its clinical prognostic value.
Methods: 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.
Results: 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).
Conclusion: 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.
题目: TGFβ1及VEGF基因在急性髓系白血病患者中的表达水平及其临床预后价值.
目的: 研究TGFβ1及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.
方法: 选取2016年7月至2018年9月间在本院接受治疗的78例AML患者,分离患者骨髓单个核细胞后,采用RT-PCR实验检测样本TGFβ1及VEGF基因水平,并分析TGFβ1及VEGF基因表达与AML患者临床特征的相关性;采用Kaplan-Meier评估患者的OS及EFS;采用Cox风险比例模型分析患者的预后危险因素.
结果: 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)。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及VEGF基因水平与AML患者的白细胞数、血红蛋白、血小板及外周血幼稚细胞呈显著相关性(r=0.83)。完全缓解的AML患者的TGFβ1水平均高于部分缓解及未缓解的患者(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患者的VEGF水平均低于部分缓解及未缓解患者(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生存分析表明,TGFβ1高表达的AML患者OS和DFS均优于TGFβ1低表达的患者(P<0.05),VEGF低表达的AML患者OS和DFS均优于VEGF高表达的患者(P<0.05)。多因素 Cox 回归分析表明,血小板、TGFβ1及VEGF基因是 OS 独立影响因素(P<0.05),白细胞、TGFβ1及VEGF基因是 DFS 独立影响因素(P<0.05).
结论: AML患者TGFβ1表达水平下降,VEGF基因水平上升,并与AML的预后密切相关,可为AML患者的临床治疗提供参考.