Role of bone marrow vascular endothelial growth factor levels in patients with diffuse large B-cell lymphoma after treatment

doi:10.3969/j.issn.1673-8640.2021.05.004

Abstract

Abstract:

Objective To investigate the role of bone marrow vascular endothelial growth factor（VEGF） levels in monitoring the curative effect of patients with diffuse large B-cell lymphoma（DLBCL）. Methods Totally,40 patients with DLBCL were enrolled. The levels of VEGF,platelet（PLT） count and lactate dehydrogenase（LDH） in bone marrow plasma were determined after treatment,and the ratio of VEGF/PLT was calculated. The clinical data of patients [age,sex,clinical stage,the Eastern Cooperative Oncology Group（ECOG） score,international prognosis index（IPI） score,cancer cell invasion into bone marrow or not,invasion and treatment response（effective or ineffective）] were collected. Spearman correlation analysis was used to evaluate the correlation among the parameters. Cox proportional hazard regression model was used to evaluate the risk factors affecting the overall survival time（OS） and progression free survival（PFS）,and the Kaplan-Meier survival curve was drawn. Results The level of VEGF in bone marrow of DLBCL patients with age≥65 years old,ECOG score≥2,IPI score>3 and ineffective treatment was higher. The PLT count of DLBCL patients whose cancer cells with bone marrow invasion was higher. The VEGF/PLT ratio of patients with age≥65 years old,cancer cells with bone marrow invasion,IPI score>3 and ineffective treatment was higher. There was a positive correlation between VEGF level and PLT count in DLBCL patients（r=0.33,P<0.05）. The ratio of VEGF/PLT in effective group was lower than that in ineffective group（P<0.05）,but there was no statistical significance in VEGF and PLT count between the 2 groups（P>0.05）. Kaplan-Meier survival curve showed that the PFS and OS of VEGF/PLT ratio<3×10^-6 pg group were higher than those of VEGF/PLT ratio≥ 3×10^-6 pg group（P<0.05）. Cox proportional hazard regression model showed that VEGF/PLT ratio was a risk factor for PFS in DLBCL patients [hazard ratio（HR）=3.277,95% confidence interval（CI） 2.276-5.901],and ECOG score,IPI score and bone marrow VEGF level were risk factors of OS in DLBCL patients（HR were 4.26,3.33 and 3.52,95%CI 3.102-5.466,2.257-5.009 and 2.620-4.104,respectively）. Conclusions The level of VEGF in bone marrow is related to the prognosis of DLBCL patients.

Key words: Vascular endothelial growth factor, Platelet count, Bone marrow, Diffuse large B-cell lymphoma

CLC Number:

R446.1

LI Bin, ZHAO Dong, HUANG Rong, GUO Juansun. Role of bone marrow vascular endothelial growth factor levels in patients with diffuse large B-cell lymphoma after treatment[J]. Laboratory Medicine, 2021, 36(5): 480-485.

Figures/Tables 5

References 17

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病理参数	VEGF/（pg/mL）	PLT计数/（×10⁶/mL）	VEGF/PLT比值/×10^-6 pg
性别
男性	542.25±125.23	225.65±22.56	2.74±0.16
女性	559.65±124.62	256.52±22.59	2.21±0.12
P值	0.85	0.16	0.55
年龄
<65岁	335.65±56.59	254.62±26.36	1.62±0.15
≥65岁	652.38±57.52	209.61±65.25	3.55±0.12
P值	0.03	0.33	<0.01
临床分期
Ⅰ~Ⅱ	586.62±102.36	235.62±63.23	1.95±0.06
Ⅲ~Ⅳ	526.34±112.63	240.11±66.59	3.05±0.14
P值	0.59	0.09	0.26
ECOG评分
0~1分	552.64±128.62	236.52±36.58	2.26±0.08
≥2分	1025.81±142.95	255.47±55.26	4.06±0.21
P值	0.03	0.52	0.16
病理参数	VEGF/（pg/mL）	PLT计数/（×10⁶/mL）	VEGF/PLT比值/×10^-6 pg
肿瘤细胞是否侵入骨髓
侵入	542.16±102.65	135.26±70.23	4.68±0.33
未侵入	561.03±115.26	244.52±81.26	2.99±0.15
P值	0.52	0.01	0.01
是否有结外侵入
结外侵入	574.26±148.26	225.62±61.02	3.32±0.52
无结外侵入	456.38±106.38	245.32±52.16	1.65±0.41
P值	0.51	0.33	0.15
LDH
<700 IU/L	574.32±88.56	229.52±93.52	3.32±0.33
≥700 IU/L	549.55±90.54	241.36±81.20	1.65±0.24
P值	0.52	0.62	0.33
IPI评分
≤3分	456.29±105.87	254.32±36.59	1.85±0.15
>3分	885.62±115.63	186.39±26.55	4.35±0.54
P值	0.02	0.15	<0.01
治疗反应
有效	406.35±125.33	286.62±35.84	1.62±0.23
无效	956.32±156.34	182.34±40.12	3.95±0.52
P值	<0.01	0.19	0.01

病理参数	VEGF/（pg/mL）	PLT计数/（×10⁶/mL）	VEGF/PLT比值/×10^-6 pg
性别
男性	542.25±125.23	225.65±22.56	2.74±0.16
女性	559.65±124.62	256.52±22.59	2.21±0.12
P值	0.85	0.16	0.55
年龄
<65岁	335.65±56.59	254.62±26.36	1.62±0.15
≥65岁	652.38±57.52	209.61±65.25	3.55±0.12
P值	0.03	0.33	<0.01
临床分期
Ⅰ~Ⅱ	586.62±102.36	235.62±63.23	1.95±0.06
Ⅲ~Ⅳ	526.34±112.63	240.11±66.59	3.05±0.14
P值	0.59	0.09	0.26
ECOG评分
0~1分	552.64±128.62	236.52±36.58	2.26±0.08
≥2分	1025.81±142.95	255.47±55.26	4.06±0.21
P值	0.03	0.52	0.16
病理参数	VEGF/（pg/mL）	PLT计数/（×10⁶/mL）	VEGF/PLT比值/×10^-6 pg
肿瘤细胞是否侵入骨髓
侵入	542.16±102.65	135.26±70.23	4.68±0.33
未侵入	561.03±115.26	244.52±81.26	2.99±0.15
P值	0.52	0.01	0.01
是否有结外侵入
结外侵入	574.26±148.26	225.62±61.02	3.32±0.52
无结外侵入	456.38±106.38	245.32±52.16	1.65±0.41
P值	0.51	0.33	0.15
LDH
<700 IU/L	574.32±88.56	229.52±93.52	3.32±0.33
≥700 IU/L	549.55±90.54	241.36±81.20	1.65±0.24
P值	0.52	0.62	0.33
IPI评分
≤3分	456.29±105.87	254.32±36.59	1.85±0.15
>3分	885.62±115.63	186.39±26.55	4.35±0.54
P值	0.02	0.15	<0.01
治疗反应
有效	406.35±125.33	286.62±35.84	1.62±0.23
无效	956.32±156.34	182.34±40.12	3.95±0.52
P值	<0.01	0.19	0.01

组别	例数	VEGF/（pg/mL）	PLT计数/（×10⁶/mL）	VEGF/PLT比值/×10^-6pg
治疗有效组	28	654.8±60.6	245.1±13.2	3.0±0.4
治疗无效组	12	661.4±48.1	252.0±11.1	3.4±0.7
t值		-0.334	-1.584	-2.293
P值		0.370	0.061	0.014

组别	例数	VEGF/（pg/mL）	PLT计数/（×10⁶/mL）	VEGF/PLT比值/×10^-6pg
治疗有效组	28	654.8±60.6	245.1±13.2	3.0±0.4
治疗无效组	12	661.4±48.1	252.0±11.1	3.4±0.7
t值		-0.334	-1.584	-2.293
P值		0.370	0.061	0.014

因素	PFS		OS
因素	HR值（95%CI）	P值	HR值（95%CI）	P值
年龄	1.061（0.130~2.482）	0.520	2.055（1.776~3.345）	0.263
ECOG评分	5.362（4.013~6.556）	0.124	4.264（3.102~5.466）	0.007
LDH	2.209（1.575~3.007）	0.153	2.242（1.781~3.234）	0.241
临床分期	2.310（1.703~3.477）	0.162	1.322（0.532~2.209）	0.482
是否有结外侵入	1.854（0.999~3.651）	0.261	1.521（0.931~3.023）	0.264
IPI评分	2.633（1.876~4.082）	0.180	3.330（2.257~5.009）	0.014
VEGF评分	1.516（0.658~3.244）	0.262	3.520（2.620~4.104）	0.020
VEGF/PLT比值	3.277（2.276~5.901）	0.014	4.261（3.222~6.231）	0.005