血管内皮生长因子与Bcl-2基因在急性淋巴细胞白血病的表达及意义

目的探讨血管内皮生长因子（VEGF）和抗凋亡基因Bcl-2在儿童急性淋巴细胞白血病（ALL）的表达与临床危险分级和早期治疗反应及其预后的关系。方法采用S-P免疫组织化学方法,检测32例ALL骨髓细胞VEGF和Bcl-2基因的表达状况,比较不同危险分级及不同的早期治疗反应的ALL患者之间的表达差别。选择同期住院的非白血病患者15例正常骨髓细胞作为对照组。结果VEGF、Bcl-2在ALL患者中表达均明显高于对照组（t=7.4917,3.2558Pa〈0.01;二者呈正相关（r=0.457P〈0.01）。VEGF、Bcl-2在高危组（HR）、中危组（MR）、标危组（SR）中的表达化疗前后均有显著性差异（F=11.570,4.558,4.574,3.013Pa〈0.05）;治疗反应好与反应差化疗前、后组间比较均有显著性差异（t=1.957,2.798,3.565,2.375Pa〈0.05）;化疗前后组内比较,反应好组有显著性差异（t=1.8038,1.7309Pa〈0.05）,反应差组均无显著性差异（t=1.3798、1.1875Pa〉0.05）;二者均低表达者与均高表达者复发率有显著性差异（P〈0.05）。结论VEGF和Bcl-2在儿童急性白血病中存在高表达,与临床高危因素分级一致,二者以不同机制参与急性白血病的发生、发展,可作为判断疾病预后的参考指标,联合检测对预后判断优于单一指标检测。

Expression of Vascular Endothelial Growth Factor and Bcl-2 Gene in Children with Acute Lymphblastic Leukemia and Its Significance

Objective To explore the relationships among the expression of vascular endothelial growth factor(VEGF) and anti-apoptosis Bcl-2 gene,various clinical risk groups,early respond to chemotherapy and their prognosis in children with acute lymphoblastic leukemia(ALL).Methods The expression of VEGF and Bcl-2 in bone marrow cells of 32 cases of ALL were detected by S-P immunohistochemical staining,and their expression difference were compared among the different clinical risk groups,and between different early treatment responds groups.Fifteen cases of bone marrow cells from non-leukemia patients were used as control group.Results Expression of VEGF or Bcl-2 in the ALL was significantly higher than those in control group(t=7.491 7,3.255 8 Pa<0.01);they were positively related(r=0.457 P<0.01).There were significant differences of expression of VEGF or Bcl-2 in the patients before and after treatment,or among different risk groups(F=11.570,4.558,4.574,3.013 Pa<0.05);There were significant difference on expression of VEGF or Bcl-2 in good response and poor response groups before and after treatment(t=1.957,2.798,3.565,2.375 Pa<0.05);the same groups comparing before and after treatment, there were significant differences in good respond group(t=1.803 8,1.730 9 Pa<0.05),and no differences in poor respond group(t=1.379 8,1.187 5 Pa>0.05).There were significant difference on expression of both them between higher and lower groups in their prognosis(Pa<0.05).Conclusions VEGF and Bcl-2 expression in children with ALL are higher, in according with clinical risk factors,and have different roles in occurrence and development of ALL. It may be more helpful of evaluating prognosis of ALL by detecting them jointly than single.