成人恶性血液病患者血管内皮生长因子的血清水平分析

目的　探讨急性髓细胞白血病和多发性骨髓瘤患者的血清VEGF水平与疾病发展的关系。方法　应用酶联免疫吸附技术和Envision免疫组化二步法 ,分别检测 4 1例次成人急性髓细胞白血病和 19例次多发性骨髓瘤患者的血清VEGF水平 ,以及部分患者的骨髓血管生成情况。分析治疗前后血清VEGF水平的差异性 ,及其与患者骨髓微血管数、部分实验室检查指标、患者临床疗效的相关性。结果　AML和MM患者血清VEGF水平在经过化疗获得缓解或部分显效后显著低于初发时水平 (P <0 0 1)。AML各亚型M2、M3、M4和M5患者的血清VEGF水平差异无统计学意义(P值 =0 12 6 ) ,但均显著低于MM初发患者的血清VEGF水平 (P <0 0 1)。AML、MM初发患者血清VEGF水平与初发时的骨髓微血管数之间无显著相关性。结论　血清VEGF水平与疾病的活动性相关 ,可能在一定程度上反映疾病的状态。有效的化疗可能通过抑制白血病细胞增殖 ,下调VEGF的分泌。

Serum level of vascular endothelial growth factor in hematological malignancies

Objective To investigate the relationship of VEGF serum level to the progression of acute leukemia and multiple myeloma. Methods The role of VEGF serum level among patients with acute leukemia in 41 cases and multiple myeloma in 19 cases were elucidated by using ELISA method. Bone marrow angiogenesis were also elucidated by using EnVision two-step immunohistochemical staining method. The differences of VEGF serum level before and after chemptherapy, and its relationship to bone marrow microvessel counts and some laboratory variables or response to chemotherapy were also analysed. Results Significant decrease in serum level of VEGF was found in patients responding to chemotherapy in comparison to pretreatment levels( P <0 01). No significant difference of VEGF level was found among different FAB subcategories of patients with acute leukemia( P =0 126), but all significant lower than patients with multiple myeloma. No significant correlation was found between VEGF serum level and bone marrow microvessel counts in newly diagnosed, untreated acute leukemia and multiple myeloma samples. Conclusion Serum level of VEGF parallel to the activity of disease, and might reflect the state of disease in a certain extent. Effective chemotherapy is accompanied by a significant decrease in secretion of VEGF by restraining proliferation of blast cells.