血管内皮生长因子在急性白血病中的表达水平及其意义

目的 探讨急性白血病（AL）血清和骨髓单个核细胞培养上清液（CSBMMNC）中血管内皮生长因子（VEGF）表达水平及其临床意义。方法 采用酶联免疫吸附法定量检测71例急性白血病和20例正常对照血清及CSBMMNC中VEGF表达水平。对其中33例初发AL患者采用2个疗程化疗。分析比较VEGF表达水平的变化与疗效的关系。结果ANLL组与ALL组初发患者血清与CSBMMNC中VEGF水平相比，差异无显著性（P〉0．05）。AL初发组、复发难治组分别与完全缓解（CR）组、正常对照组血清及CSBMMNC中VEGF表达水平相比有非常显著性差异（P均〈0．01）。但复发难治组与初发组相比差异无显著性（P均〉0．05）。初发AL血清与CSBMMNC中VEGF水平与骨髓原始细胞数呈显著正相关（r值分别为0．521和0．849，P均〈0．01）。33例初发AL患者采用2个疗程化疗，血清及CSBMMNC中高表达组CR率（36．36％）较低表达组CR率（90．90％）低，有非常显著性差异（P均〈0．01）。结论 动态检测血清及CSBMMNC中VEGF水平可在一定程度上了解AL的状态和体内白血病细胞的总负荷量，对AL的疗效及预后判断有一定的指导意义。

Expression and Clinical Significance of Vascular Endothelial Growth Factor in Patients with Acute Leukemia

Objective To determine the levels of vascular endothelial growth factor(VEGF) in serum and cultural supernatant of bone marrow mononuclear cell(CSBMMNC) from patients with acute leukemia(AL) and its clinical significance.Methods The levels of VEGF in serum and CSBMMNC were measured by sandwich enzyme-linked immunosorbent assay(ELISA) method in 71 patients with AL and 20 normal-control subjects.Give 2 cycles of conventional chemotherapy to the newly diagnosed patients with AL and analysis the relationship of the levels of VEGF and the response to treatment.Results In newly diagnosed patients with AL,the differences in the serum and CSBMMNC levels of VEGF between the ANLL group and the ALL group were not significant(both P>0.05).The difference in the serum and CSBMMNC levels of VEGF between newly diagnosed/relapsing/refractory patients and CR patients with AL were significant(both P<0.01);The differences of VEGF between newly diagnosed patients and relapsing/refractory patients were not significant(both P>0.05);The same as newly diagnosed/relapsing/refractory patients and normal-control subjects.The serum and CSBMMNC levels of VEGF were markedly correlated with the count of blast cells in bone marrow(the r value were 0.521 and 0.849 respectively,both P<0.01).In the 33 newly diagnosed patients with AL which be given 2 cycles of conventional chemotherapy,the CR rates in the AL patients with the serum and CSBMMNC VEGF levels above the median(36.36%)were lowerer than the AL patients with below the median(90.90%).There were significantly different(both P<0.01).Conclusion Dynamically testing the change of serum and CSBMMNC levels of VEGF may help to get a good knowledge of the quantity of leukemia cell and the status of AL patients in certain degree.The levels of VEGF can be used as a guide to the assistance index of the response to treatment and the prognosis judgment of AL.