抗凋亡因子Bcl-2和血管内皮细胞生长因子(VEGF)在急性白血病中表达及意义

目的探讨抗凋亡因子Bcl_2及血管内皮细胞生长因子 (VEGF)在急性白血病患儿的表达及其与临床病理特征的关系。方法采用免疫组织化学法检测40例急性白血病患儿治疗前后Bcl_2及VEGF的表达。结果Bcl_2及VEGF在急性白血病患儿中表达明显高于对照组 (P均<0.05) ,治疗后完全缓解组两者表达水平均明显下降 ,与对照组差异无显著性 (P均>0.05)。结论急性白血病中存在Bcl_2及VEGF高表达 ,可能与急性白血病的发病、发展及疾病的预后有关。

The expression of Bcl-2 and VEGF in patients with acute leukemia and their clinical significance

Objective To explore the significance of Bcl_2 and vascular endothelial growth factor(VEGF)expression in the patients with acute leukemia and their relationship to the clinical features,and further search for the new treatment regimes in patients with acute leukemia.Methods 40 acute leukemia patients aged from 5_18 years(the average age is 10.5 years)were included in this study.Among them,30 cases with acute lymphocyte leukemia(ALL),10 cases with acute non_lymphocyte leukemia(ANLL),and 18 normal children were recruited as normal controls.The difference in age and sex between two groups was not significant.The samples were assayed to study the expression of Bcl_2 and VEGF before and after induction chemotherapy with immonohistochemical staining.Results (1)The expression of Bcl_2 and VEGF in AL patients was markedly higher than that in normal subjects,and these two parameters had positive correlation with the process of AL(rs=0.836,P<0.001).(2)The expression of Bcl_2 and VEGF in the patients with complete remission (CR) was greatly reduced in comparison with that before chemotherapy(P<0.05).But the expression of Bcl_2 and VEGF was not significantly different between CR patients and normal controls(P>0.05).While the expression of Bcl_2 and VEGF in the patients without CR was lower than that before treatment with no significant difference(P>0.05),but it was still markedly higher than that in normal controls.Furthermore,the expression of Bcl_2 and VEGF significantly varied between CR group and non_CR group before chemotherapy(P<0.05).(3)The expression of Bcl_2 and VEGF was not significantly different between ALL and ANLL.Neither of their sex correlated with the expression.Conclusion The expression of Bcl_2 and VEGF in acute leukemia patients was markedly high and these two parameters had positive correlation with the process of AL but no correlation with the sex.The high expression of Bcl_2 and VEGF might promote the development of refractory leukemia.The assay of the expression may help to predict the prognosis of AL.The lower expression of Bcl_2 and VEGF in CR testify the significance of using the antisense oligonucleotide and monoclonal antibody techniques to block their expression and/or their conjugation with the receptors to achieve the anti-cancer target.