| Abstract | Cilj istraživanja: Cilj ovog istraživanja bio je istražiti serumsku koncentraciju kalprotektina u bolesnika s Philadelphia negativnim mijeloproliferativnim neoplazmama (MPN) i procijeniti njegove kliničke korelacije.
Ispitanici i metode: Koristeći ELISA test izmjerili smo razine serumskog kalprotektina u 43 bolesnika s MPN [13 sa esencijalnom trombocitemijom (ET), 16 s policitemijom verom (PV) i 14 s primarnom mijelofibrozom (PMF)] i u 17 zdravih kontrola. Rezultati: Sva tri entiteta unutar MPN spektra imala su više serumske koncentracije kalprotektina u usporedbi sa kontrolnom grupom (p<0,001). Međutim, nije bilo razlike u razini serumskog kalprotektina između bolesnika s ET, PV i PMF (p=0,220). Prijelomna vrijednost kalprotektina >1,11 μg/mL ima osjetljivost od 81,4% i specifičnost od 88,2% za detekciju bolesnika s MPN (AUC 0,867, STD±0,047, 95% CI 0,775-0,958, p<0,001). Više koncentracije serumskog kalprotektina povezane su sa starijom dobi (p=0,007), CRP-om (p<0,001), lošijim performansom statusom (p<0,001), konstitucijskim simptomima (p=0,006), potrebom za liječenjem hidroksiurejom (p=0,004), retikulinskom fibrozom koštane srži (p<0,001) i kardiovaskularnim rizičnim čimbenicima (p=0,005). Serumski kalprotektin nije korelirao sa spolom, mutacijskim statusom, brojem leukocita, granulocita i trombocita, hemoglobinom, hematokritom ili prisutnošću palpabilne splenomegalije.
Zaključci: Povišene koncentracije serumskog kalprotektina u bolesnika s MPN vjerojatno odražavaju stanje kronične upale, ne nužno i stupanj mijeloproliferacije. Dodatna istraživanja na većem broju bolesnika s MPN su potrebna kako bi potpuno razjasnila ulogu kalprotektina u patogenezi MPN, ali i njegove prognostičke posljedice. |
| Abstract (english) | Objectives: The aim of our study was to investigate serum calprotectin levels in Philadelphia negative myeloproliferative neoplasms (MPNs) and to assess its clinical correlations.
Patients and Methods: Using ELISA test we measured serum calprotectin levels in 43 MPN patients [13 essential thrombocythemia (ET), 16 polycythemia vera (PV) and 14 primary myelofibrosis (PMF)] and in 17 healthy controls.
Results: All three MPN disorders (ET, PV and PMF) had higher serum calprotectin levels when compared to controls (p<0.001). However, there was no difference in serum calprotectin levels between ET, PV and PMF patients (p=0.220). According to the ROC curve analysis, when the cut–off value of calprotectin is >1.11 μg/mL, serum calprotectin has a sensitivity of 81.4% and specificity of 88.2% for detection of patients with MPNs (AUC 0.867, STErr±0.047, 95% CI 0.775-0.958, p<0,001). Higher serum calprotectin levels were associated with older age (p=0.007), higher CRP (p<0.001), poor performance status (p<0.001), constitutional symptoms (p=0.006), the need for hydroxycarbamide therapy (p=0.004), reticulin fibrosis (p<0.001) and the presence of cardiovascular risk factors (p=0.005). Serum calprotectin did not correlate with sex, mutational status, leukocyte, granulocyte and platelet counts, hemoglobin and hematocrit levels, or the presence of palpable splenomegaly.
Conclusions: Elevated serum calprotectin levels in patients with MPNs might primarily reflect the state of chronic inflammation, not necessarily the extent of myeloproliferation. Further studies are needed to elucidate the role of calprotectin in the pathogenesis of MPN's, as well as its prognostic implications. |
