骨髓增生异常综合征患者血清TGF-β1、SDF-1水平变化与预后的关系-东南大学学报医学版

骨髓增生异常综合征患者血清TGF-β1、SDF-1水平变化与预后的关系

单位：郑州大学第一附属医院血液内科三病区, 河南郑州 450000

分类号：R551.3

出版年·卷·期（页码）：2024·43·第五期（736-741）

摘要：

目的: 探讨骨髓增生异常综合征(MDS)患者血清转化生长因子β1(TGF-β1)和基质细胞衍生因子1(SDF-1)表达水平变化与预后的关系。方法: 研究组选取92例在本院确诊治疗的MDS患者,对照组选取92例进行健康体检的志愿者(2021年1月至2023年6月)。采用酶联免疫吸附(ELISA)法测定研究组与对照组血清TGF-β1、SDF-1的水平变化;多因素Logistic回归探讨预后不良的影响因素;采用受试者工作特征(ROC)曲线评估TGF-β1、SDF-1对患者预后的预测价值。结果: 与对照组相比,研究组血清TGF-β1水平显著下降,SDF-1水平显著上升(均P＜0.05)。且随着IPSS评分等级的增加,TGF-β1的水平呈显著下降趋势,SDF-1的水平呈显著上升趋势(P＜0.05)。预后不良组TGF-β1水平显著低于预后良好组,SDF-1水平显著高于预后良好组(均P＜0.05)。多因素Logistic回归分析结果显示,TGF-β1低表达水平为MDS患者预后不良的危险因素,SDF-1高表达水平为MDS患者预后不良的危险因素(P＜0.05)。根据ROC曲线得知,血清TGF-β1、SDF-1预测MDS患者预后的AUC分别为0.754、0.798,两者联合预测的AUC显著大于TGF-β1、SDF-1单独预测的AUC(Z _TGF-β1=2.733、Z _SDF-1=2.162,均P＜0.05)。结论: MDS患者血清TGF-β1表达水平降低,而SDF-1表达水平升高,二者是影响MDS患者预后的因素,联合TGF-β1、SDF-1表达水平预测MDS患者预后的价值较高。

Objective: To explore the relationship between changes of serum transforming growth factor-β1(TGF-β1) and stromal cell derived factor 1(SDF-1) expression levels with prognosis in patients with myelodysplastic syndrome(MDS). Methods: 92 MDS patients diagnosed and treated in our hospital were selected as the research group, and a control group of 92 volunteers who underwent health checkups were selected(January 2021 to June 2023). Enzyme linked immunosorbent assay(ELISA) was applied to compare the changes of serum levels of TGF-β1 and SDF-1 between the research group and the control group. The multivariate Logistic regression analysis was used to investigate the causes of poor prognosis; the prognostic value of TGF-β1 and SDF-1 was evaluated by receiver operating characteristic(ROC) curve. Results: Compared with the control group, the expression of serum TGF-β 1 level in research group was significantly down-regulated, and the expression of SDF-1 level was significantly up-regulated(all P<0.05). As the IPSS score level increased, the level of TGF-β1 showed a obvious downward trend, while the level of SDF-1 showed a obvious upward trend(P<0.05). The level of TGF-β1 in the poor prognosis group was obviously lower than that in the good prognosis group, and the level of SDF-1 was obviously higher than that in the good prognosis group(all P<0.05). Multivariate Logistic regression analysis showed that low TGF-β1 level and high SDF-1 level were risk factors for poor prognosis in MDS patients(P<0.05). According to the ROC curve, the AUC predicted by serum TGF-β1 and SDF-1 for predicting the prognosis of MDS patients were 0.754 and 0.798, respectively. The AUC predicted by the combination of the two was obviously higher than that predicted by TGF-β1 and SDF-1 alone(Z_TGF-β1=2.733, Z_SDF-1=2.162, all P<0.05). Conclusion: The expression level of serum TGF-β1 decreases in MDS patients, while the expression level of SDF-1 increases. Both are factors that affect the prognosis of MDS patients. The combination of the expression levels of TGF-β1 and SDF-1 have high value in predicting the prognosis of MDS patients.

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