(PA-352) The Study of Serum VEGF Expression in Different Types of Plasma Cell Diseases

Although VEGF levels are elevated in many other plasma cell diseases besides POEMS syndrome,, the clinical characteristics and diagnostic value of VEGF and other plasma cell diseases have not been thoroughly discussed in existing research and clinical practice. The purpose of this study was to analyze the difference of VEGF expression levels in different plasma cell diseases, explore its correlation with clinical characteristics and its diagnostic value.

Methods:

 A retrospective study was conducted to select 181 patients with plasma cell diseases,including POEMS syndrome, MGUS,MGRS,pAL,MM,pPCL. We compared serum VEGF levels in patients with various plasma cell diseases, and assessed the relationship between VEGF levels in general and clinical indicators in each disease ,with P< 0.05 as the level of statistical significance.

Results:

1. The level of VEGF in patients with POEMS syndrome was significantly higher than that in patients with MGUS, pAL, MGRS, pPCL and MM (P< 0.01). VEGF levels in MGUS, pAL and MGRS patients were significantly higher than those in MM and pPCL patients.

2. In the overall analysis of 181 patients with plasma cell disease, It can be seen that the proportion of bone marrow plasma cells and the proportion of abnormal plasma to total plasma cells in POEMS syndrome, MGUS and MGRS were lower than those in pAL, MM and pPCL, while the proportion of serum VEGF was higher than the upper limit of normal value.

3.The disease progression of the high VEGF expression group was later(P=0.018). the survival trend of the high expression group was better (P=0.051).

4.VEGF was negatively correlated with the proportion of plasma cells in bone marrow smear and the proportion of abnormal plasma cells in total plasma cells ( P < 0.05), and positively correlated with platelet and hemoglobin ( P < 0.05), besides, VEGF is related to various clinical features in POEMS syndrome.

5.VEGF levels in MGUS patients were positively correlated with WBC and NUET (P < 0.05). VEGF levels were positively correlated with serum LDH in pAL patients ( P=0.038). VEGF was positively correlated with platelets in MM patients (P=0.012), There was a negative correlation between VEGF and β₂MG in pPCL patients (rs=-0.661, P=0.038)

6. the cutoff value of the differentiation between POEMS syndrome and MGUS MGRS、pAL、MM、pPCLwas 402.93、 277.21、424.34、151.185、152.91pg/mLrespectively.

Conclusions:

VEGF was negatively correlated with the proportion of total plasma cells and the proportion of abnormal plasma cells.  However, when the proportion of abnormal plasma cells in the bone marrow was significantly increased, VEGF levels were inhibited and the correlation with tumor load was weakened. In addition, there are differences in the differential diagnostic threshold of VEGF between plasma cell diseases and POEMS syndrome, which should be carefully screened clinically.