血管免疫母细胞性T细胞淋巴瘤患者血管内皮生长因子C表达的分析

目的探讨血管内皮生长因子C（VEGF—C）在恶性淋巴瘤患者淋巴瘤组织中的表达及其与疾病进展的关系。方法运用实时定量PCR方法检测了81例恶性淋巴瘤患者淋巴瘤组织中VEGF—C的表达。联合激光微切割技术和定量PCR法从淋巴瘤组织中特异性分离淋巴瘤细胞，检测淋巴瘤细胞中VEGF—C的表达。同时通过电镜对淋巴瘤组织切片中血管结构进行观察。结果与淋巴结反应性增生患者（8例）淋巴结的VEGF—C表达量（1．55±0、19）相比，血管免疫母细胞性T细胞淋巴瘤患者（18例）组织（15．35±9．07）和微切割的患者（10例）淋巴瘤细胞（15．19±4．28）均高表达VEGF—C（P值分别为0．0020和〈0、01）。VEGF—C高表达的患者常伴骨髓浸润（P=0．0039）和皮肤累及（P=0．0046），国际预后指数分组多为高危组（P=0．0302）。VEGF—C高表达者存在血管结构异常，表现为血管内皮细胞肿胀，或缺乏周围细胞。结论VEGF—C表达与血管免疫母细胞性T细胞淋巴瘤的疾病进展密切相关。

Analysis of overexpression of vascular endothelial growth factor-C in patients with angioimmunoblastic T-cell lymphoma

OBJECTIVE: To explore the vascular endothelial growth factor-C (VEGF-C) expression and its clinical significance in malignant lymphoma. METHODS: Lymphoma cells were isolated by laser microdissection. VEGF-C expression in lymphoma tissue and microdissected lymphoma cells was measured by realtime quantitative PCR. Meanwhile, vessel ultrastructure was identified by transmission electron microscopy. RESULTS: Comparing with that in 8 patients with reactive lymphocyte hyperplasia, VEGF-C was overexpressed in angioimmunoblastic T-cell lymphoma, both in lymphoma tissue (n = 18, P = 0.0020) and in microdissected lymphoma cells (n = 10, P < 0.0001). Increased VEGF-C level was associated with bone marrow infiltration (P = 0.0039), skin involvement (P = 0.0046) and high-risk international prognostic index (P = 0.0302). In VEGF-C overexpressed cases, ultrastructural study showed dystrophic vessels, with turgescent endothelial cells and absence of pericytes. CONCLUSION: The value of VEGF-C expression might be a biomarker of disease progression in angioimmunoblastic T-cell lymphoma.