摘要
目的 探究血清血管内皮生长因子（VEGF）水平对POEMS综合征的诊断意义及其临床相关性.方法 收集104例POEMS综合征患者的临床资料,测定其血清VEGF水平,并与类似疾病组（多发性骨髓瘤15例、轻链型淀粉样变10例、Castleman病11例、慢性炎性脱髓鞘病18例）患者及28名健康对照者血清VEGF结果进行比较,利用受试者工作曲线确定出血清VEGF用于诊断POEMS综合征的最佳阈值.同时分析与高水平血清VEGF相关的临床特点.结果 104例患者中男67例,女37例,中位年龄46（24～74）岁.POEMS综合征组患者中位血清VEGF水平为3 503 ng/L,较类似疾病组（分别为179、549、356和949 ng/L）和对照组（304 ng/L）均升高（P值均＜0.01）.当选取血清VEGF＞1200 ng/L作为诊断标准时,其诊断POEMS综合征的特异性和敏感性分别为90.2％和83.7％.与低水平血清VEGF患者相比较,高水平组患者（血清VEGF＞2 000 ng/L）硬化性骨病（61.0％对37.0％,P=0.031）及视乳头水肿（70.1％对44.4％,P=0.017）发生率更高.结论 血清VEGF水平用于诊断POEMS综合征具有较高的诊断特异性和敏感性,其水平和个别临床特点具有一定相关性.
Objective To evaluate the diagnostic performance and clinical correlation of serum vascular endothelial growth factor （VEGF） in patients with newly diagnosed POEMS syndrome.Methods We recruited 104 patients with POEMS syndrome who diagnosed at Peking Union Medical College Hospital during October 2010 to April 2014 in the current study.Clinical data and serum samples were collected.Serum VEGF levels were measured,comparing to both disease and healthy controls,and its correlation with clinical features were analyzed.Results Patients with newly diagnosed POEMS syndrome showed markedly elevated levels of serum VEGF （median 3503 ng/L,P〈0.01）.A cut-off value of 1 200 ng/L had a specificity of 90.2%,with a sensitivity of 83.7%,in support of a POEMS diagnosis.Further analyses indicated that patients with higher serum VEGF level （〉2 000 ng/L） had more prevalent osteosclerosis （61.0% vs 37.0%,P=0.031） and papilledema （70.1% vs 44.4%,P=0.017）.Conclusions Serum VEGF level was useful in differentiating POEMS syndrome from other disorders with overlapping clinical presentations,and its levels correlated with several disease features.
出处
《中华血液学杂志》
CAS
CSCD
北大核心
2014年第12期1065-1068,共4页
Chinese Journal of Hematology
基金
卫生公益性行业科研专项（201202017）
教育部高等学校博士学科点专项科研基金（2013110611000）
北京市自然科学基金（7142130）
北京市首发专项基金（2011-4001.03）
关键词
POEMS综合征
诊断
参考标准
POEMS syndrome
Vascular endothelial growth factor A
diagnostic
Reference standards
