摘要目的 研究多发性骨髓瘤(MM)患者血清Dickkopf-1(DKK-1)、可溶性核因子κB配体受体激活剂(sRANKL)、护骨素(OPG)和骨代谢因子[碱性磷酸酶(ALP)、抗酒石酸酸性磷酸酶(TRACP-5b)]水平及其与MM分期、溶骨性病变的关系,探讨骨代谢及调节因子DKK-1和sRANKL在MM骨病中的临床意义.方法 采用双抗体夹心ELISA检测30例初诊MM患者和20例健康人血清DKK-1、sRANKL、OPG、ALP、TRACP-5b等骨代谢因子及调节因子的水平.结果 MM患者血清DKK-1、sRANKL、OPG和TRACP水平均显著高于健康人,分别为42.96μg/L比5.33 μg/L,1.83pmol/L比0.79 pmol/L,1799.30 pmol/L比822.40 pmol/L,5.81 U/L比0.28 U/L,P值均＜0.05.国际分期系统(ISS)分期Ⅲ期患者血清DKK-1水平(46.33 μg/L)和sRANKL(2.26 pmol/L)水平显著高于Ⅰ/Ⅱ期患者(37.91μgL和1.19 pmol/L,P值均＜0.05).3处以上与1～3处溶骨病变患者相比,血清DKK-1、sRANKL和TRACP-5b水平显著升高(46.30μg/L比31.98μg/L,2.18 pmol/L比0.69 pmol/L,6.02 U/L比5.13 U/L,P值均＜0.05).结论 MM患者血清DKK-1、sRANKL、OPG和TRACP-5b水平均显著高于健康人;血清DKK-1、sRANKL水平与MM分期及溶骨病变程度相关.

abstractsObjective To detect serum concentrations of Dickkopf-1(DKK-1) and soluble receptor activator of nuclear factor-κB ligand (sRANKL) in patients with multiple myeloma (MM) and to investigate its clinical significance. Methods Serum DKK-1, sRANKL, osteoporotegerin(OPG) and tartrate-resistant acid phosphatase 5b (TRACP-5b) levels were quantified in 30 newly diagnosed MM patients and 20 healthy control subjects by using sandwich ELISA. Results The serum DKK-1, sRANKL,OPG and TRACP-5b levels were significantly higher than those in the healthy controls (42.96 μg/L vs 5.33 μg/L, 1.83 pmol/Lvs 0. 79 pmol/L, 1799. 30 pmol/L vs 822.40 pmol/L, 5.81 U/L vs 0. 28 U/L, respectively; all P＜0. 05). Serum levels of DKK-1 were positively correlated with sRANKL and TRACP-5b, respectively.Serum concentrations of DKK-1 and sRANKL were significantly elevated in stage Ⅲvs stages Ⅰ and Ⅱaccording to International Staging System (ISS) (46. 33 μg/L vs 37.91 μg/L, 2.26 pmol/L vs 1.19pmol/L, respectively, all P ＜0.05). Serum concentrations of DKK-1 , sRANKL and TRACP-5b were significantly higher in patients with more than 3 lytic bone lesions than those with only 1-3 lytic bone lesions (46. 30 μg/L vs 31.98 μg/L, 2. 18 pmol/L vs 0. 69 pmol/L, 6.02 U/L vs 5. 13 U/L, all P ＜ 0.05).Conclusions MM patients have increased serum DKK-1, sRANKL, OPG and TRACP-5b levels as compared with the healthy controls. Serum concentrations of DKK-1 and sRANKL have close relationship with MM stage and lytic bone disease.