急性髓系白血病患儿骨髓细胞中血管内皮生长因子及其受体的变化

目的探讨儿童急性髓系白血病(AML)骨髓细胞中血管内皮生长因子(VEGF)及其受体(VEGFR)的表达差异,分析其与儿童急性髓系白血病临床特征的关系,以及化疗前后的变化。方法采用SP免疫组化方法检测20例AML患儿治疗前后以及对照组骨髓中VEGF/VEGFR(Flt-1和KDR)的表达情况。结果VEGF、Flt-1、KDR在AML患儿骨髓中表达水平高于对照组。化疗后获得完全缓解(CR)14例患儿的VEGF、Flt-1、KDR表达在化疗后比化疗前显著降低;化疗后未获得CR的6例患儿的表达化疗前后差异无统计学意义。AML患儿的VEGF表达与骨髓中幼稚细胞百分比、外周血中幼稚细胞百分比呈正相关。骨髓中VEGF、Flt-1、KDR的表达水平在不同年龄、不同性别、有无髓外浸润差异无统计学意义。高表达的VEGF组缓解率低于低表达组。结论VEGF、Flt-1、KDR在AML患儿中呈高表达,提示可能与儿童急性白血病发生过程与预后有关。

Expression of vascular endothelial growth factor and its receptor in bone marrow of children with acute myeloid leukemia

Objectives To investigate the expression of vascular endothelial growth factor(VEGF)and its receptor(VEGFR)in bone marrow of children with acute myeloid leukemia(AML),and explore their relationship with clinical features and changes before and after chemotherapy. Methods Expression of VEGF/VEGFR(KDR,Flt-1)and their changes before and after chemotherapy were studied in bone marrows from 20 children with AML using SP immunohistochemical staining. The relationship between VEGF/VEGFR expression and clinical features was also evaluted. Results The expression of VEGF,Flt-1,KDR was significantly higher in newly diagnosed AML patients than that of control group. The expression of VEGF,Flt-1,KDR in 14 AML children with complete remission(CR)were significantly lower after chemotherapy than that before chemotherapy,while there was no differences of expression in other 6 AML children without CR before and after chemotherapy. There was a positive correlation between expression of VEGF and the percentage of leukemic cells in bone marrow and peripheral blood. No correlation was found between expressions of VEGF ,Flt-1,KDR and age,gender,extramedullary infiltration. The CR rate in high level VEGF expression patient was lower than that in patients with low VEGF expression. Conclusions Levels of expression of VEGF,Flt-1,KDR in bone marrow of children with AML were increased. VEGF/VEGFR may play an important role in pathogenesis and prognosis of childhood AML.