血清血管内皮生长因子对 POEMS综合征的早期诊断

摘要

Objective To study the significance of serum VEGF ( vascular endothelial growth factor ) in the differential diag-nosis between POEMS syndrome and peripheral neuropathy , and the value of detection of VEGF in the early diagnosis of POEMS syn-drome.Methods 30 patients were collected in PLA General Hospital from June 2012 to June 2014.18 patients were diagnosed as having POEMS syndrome in the study group and 12 patients diagnosed as having peripheral neuropathy in as the control group .All of them underwent the detection of serum VEGF levels .Results The data displayed that the mean concentration of VEGF in POEMS syndrome group, (687.85 ±179.07) pg/ml (4.8 times of normal value ), was higher than that in the control group ,(301.07 ± 112.53)pg/l (2.1 times of normal value); there was a statistically significant difference between the two groups (t=5.783, P<0.01).The diagnostic area under curve (AUC) was 0.970, cut-off value was 409.33 pg/ml, sensitivity was 1.000, specificity was 0.800, and accuracy was 0.968 respectively.Conclusions VEGF is a very important serological marker of POEMS syndrome .It is helpful for the differential diagnosis of POEMS syndrome and other peripheral neuropathy .The elevated level of serum VEGF value may be meaningful for the diagnosis of the disease , the high VEGF value supports the diagnosis of POEMS syndrome .%目的 探讨血清血管内皮生长因子(vascular endothelial growth factor ,VEGF)在鉴别综合征和周围神经病中的作用. 探讨检测血清VEGF对POEMS综合征早期诊断的价值. 方法 收集2012-06至2014-06解放军总医院神经内科住院患者30例,POEMS综合征作为病例组(12例),周围神经病作为对照组(18例). 分别于治疗前晨起空腹用肝素抗凝管采集患者外周血5 ml,用酶联免疫吸附法检测血清VEGF水平. 比较两组患者的血清VEGF值. 结果 病例组患者血清VEGF的平均值为(687.85 ±179.07)pg /ml(正常值的4.8倍),对照组患者血清VEGF的平均值为(301.07 ±112.53) pg /ml(正常值的2.1倍). 两组比较差异有统计学意义(t=5.783,P<0.01). 血清VEGF 诊断POEMS综合征的曲线下面积为0.970,95%CI(0.751~1.000),由ROC曲线可得VEGF最优Cutoff 值为409.33 pg /ml,敏感度为1.000,特异度为0.800,准确度0.968.结论 VEGF是POEMS 综合征非常重要的血清学标志物,有助于鉴别POEMS综合征和周围神经病. 血清VEGF值越高越支持POEMS综合征的诊断.