摘要
目的探讨血清Wnt通路抑制抑制因子Dickkopf-1(DKK1)、凋亡抑制蛋白生存素(Survivin)与难治性多发性骨髓患者FVAD方案(氟达拉滨、长春新碱、表阿霉素和地塞米松)化疗疗效的关系。方法选取2017年1月—2019年1月在西安医学院第一附属医院治疗的难治性多发性骨髓瘤患者81例,均给予FVAD方案化疗,观察治疗效果,检测血清DKK1、Survivin水平。结果达到完全缓解(CR)患者23例,部分缓解(PR)患者31例,疾病稳定(SD)患者17例,疾病进展(PD)患者10例,治疗有效率为66.67%;治疗有效患者治疗后血清KK1、Survivin水平分别为(3.54±0.97)ng/ml和(81.46±5.57)ng/L,明显低于治疗无效患者,差异有统计学意义(P<0.05);治疗前后血清DKK1、Survivin水平变化值预测患者治疗有效的ROC曲线下面积分别为0.733和0.693,差异有统计学意义(P<0.05),截断值分别为4.03ng/ml和26.54ng/L,灵敏性分别为77.80%和88.00%,特异性分别为63.00%和48.10%。结论在难治性多发性骨髓瘤患者中,FVAD方案化疗有效者治疗后DKK1、Survivin水平明显降低,治疗前后变化值在预测治疗疗效中有一定应用价值。
Objective To investigate the relationship between serum Wnt pathway inhibitor Dickkopf-1(DKK1),apoptosis inhibiting protein survival factor(Survivin)and the chemotherapy effect of FVAD regimen(fludarabine,vincristine,epirubicin and dexamethasone)in refractory multiple myeloid patients.Methods Eighty one patients with refractory multiple myeloma who were treated in The First Affiliated Hospital of Xi’an Medical College from January 2017 to January 2019 were all given fvad chemotherapy,the therapeutic effect was observed and the levels of serum DKK1 and Survivin were measured.Results 23 patients achieved complete remission(CR),31 patients achieved partial remission(PR),17 patients achieved disease stability(SD),10 patients achieved disease progression(PD),and the effective rate was 66.67%;The levels of KK1 and Survivin after treatment in patients with effective treatment were(3.54±0.97)ng/ml and(81.46±5.57)ng/L,which were significantly lower than those of patients without effective treatment,the difference was statistically significant(P<0.05);The area under ROC curve of changes of serum DKK1 and Survivin levels before and after treatmentpredicted the effectiveness of treatmentwas 0.733 and 0.693(P<0.05),cut-off values were 4.03 ng/ml and 26.54 ng/L,sensitivity were 77.80%and 88.00%,specificity were 63.00%and 48.10%,respectively.Conclusion In patients with refractory multiple myeloma,the levels of DKK1 and Survivin in patients with effective FVAD chemotherapy decrease significantly after treatment,and the changes before and after treatment have certain application value in predicting the therapeutic effect.
作者
赵建强
倪增峰
贾文华
马李洁
ZHAO Jianqiang;NI Zengfeng;JIA Wenhua;MA Lijie(Department of Hematology,The First Affiliated Hospital of the Xi’an Medical University,Xi’an 710077,China)
出处
《中国煤炭工业医学杂志》
2021年第5期526-529,共4页
Chinese Journal of Coal Industry Medicine
基金
陕西省教育厅专项科研计划项目(编号:20JK0893)
