血管内皮生长因子在儿童急性白血病的表达及与预后的关系

目的探讨血管内皮生长因子(VEGF)在儿童急性白血病(AL)患者的表达状况及其与长期预后的关系。方法采用S-P免疫组织化学方法,检测41例自愿受试的急性白血病患者治疗前后、缓解前后骨髓细胞VEGF的表达状况并随访预后。选择同期住院的非白血病患者15例正常骨髓作为对照组。结果VEGF在急性白血病患者中表达明显高于对照组(t=8.780、P<0.01),在急性白血病患者中阳性表达状况与骨髓中原始细胞数呈显著正相关(r=0.536);一个标准化疗后ALL组、ANLL组VEGF表达水平明显下降(t分别为6.7733、6.6294;p均<0.01),仍高于正常对照组(t分别为2.7829、3.8985;p均<0.01);未缓解组患者化疗前表达显著高于缓解组及对照组(t分别为2.0580、5.1890、p均<0.05),未缓解组患者化疗后VEGF表达下降,但较化疗前无显著性差异(t=1.3158、p>0.05),显著高于化疗后缓解组患者及对照组病例(t分别为4.1191、4.7760、p均<0.01)。随访3年VEGF高表达组死亡及复发等不良预后率显著高于低表达组(χ2=2.7619、p<0.05)。结论VEGF在儿童急性白血病患者中存在高表达,一定程度上可能反映体内白血病细胞的总负荷量、疾病状态和预后;化疗未缓解组持续高表达,化疗缓解患者表达明显下降,血清VEGF水平可以作为诊断和预测白血病发生、是否难治的有效指标。

Relationship between the expression of vascular endothelial growth factor in children with acute leukemia and its prognosis and their clinical significance

Objective To explore their relationship between the expression of vascular endothelial growth factor in children with acute leukemia and their prognosis, and its clinical significance. Methods The expression of VEGF in bone marrow cell of 41 cases of acute leukemia were detected in before and after treatment and remission respectively by S-P immunohistochemical staining, and following its prognosis, 15 cases of normal bone marrow cell were regarded as control group with no-leukemia patients in the same period. Results The expression of VEGF in acute leukemia were significantly higher than ones in the control group (t=8.780, p<0.01) and their expression were significantly positive correlation with amounts in bone marrow cell(r=0.536); VEGF of ALL group and ANLL group were significantly low in 4-6 weeks of treatment (t=6.7733, 6.6294, p<0.01) and significantly higher than ones in control group (t=2.7829, 3.8985:p<0.01); VEGF of the cases in no-remission group before treatment were significantly higher than ones in remission group and control group (t= 2.0580, 5.1890, p<0.05); VEGF of the cases in no-remission group after treatment were lower than before treatment, there were no significant difference between them (t=1.3158, p>0.05) , there were significant difference between no-remission group after treatment and the remission group and control group (t=4.1191,4.7760, p<0.01) . The mortality and recurrant rate was significantly higher in high expression group than low expression group (χ2=2.7619, p<0.05).Conclusion VEGF expression in children with acute leukemia were high, it may reflecting the amount of leukemia cell and serious state of disease and its prognosis;their expression were continuously higher after chemotherapy than before chemotherapy in no-remission group, their expression were significantly lower than before chemotherapy in remission, it may be regarded as an effective index determining in diagnose and occurrance and treatment of leukemia.