急性白血病患儿骨髓细胞血管内皮生长因子及其受体表达

目的探讨儿童急性白血病（AL）骨髓细胞血管内皮生长因子（VEGF）及其受体（Flt,KDR）表达差异,分析其与儿童AL临床特征关系及化疗前后变化。方法采用S-P免疫组织化学方法检测53例AL患儿治疗前后及对照组骨髓VEGF/Flt-1,KDR表达情况,其中急性淋巴细胞白血病（ALL）33例,急性髓系白血病（AML）20例;对照组21例为骨髓像正常非恶性血液病患儿,抽取骨髓肝素抗凝,应用梯度离心法分离单个核细胞。结果VEGF、Flt-1、KDR在AL患儿骨髓中表达水平高于对照组,AML组表达高于ALL组。化疗后完全缓解（CR）40例患儿,其VEGF、Flt-1、KDR的表达在化疗后较化疗前显著性降低;化疗后未获得CR患儿的表达在化疗前后无显著性。AL患儿VEGF的表达与骨髓中幼稚细胞百分比、外周血幼稚细胞百分比呈正相关。骨髓VEGF、Flt-1、KDR表达水平在不同年龄、性别、有无髓外浸润无差异。高表达VEGF组缓解率低于低表达组。结论VEGF、Flt-1、KDR在儿童AL中高表达,提示可能与儿童AL的发生过程、发展、疾病预后有关。

Expression of Vascular Endothelial Growth Factor and Its Receptor of Bone Marrow in Children with Acute Leukemia

Objective To investigate the expression of vascular endothelial growth factor/vcascular endothelial growth factor receptor(VEGF/VEGFR) in bone marrow of children with acute leukemia(AL),and explore their relationship of the clinical features,and observe changes before and after chemotheropy.Methods The bone marrows of 53 children with AL were assayed to study the expression of VEGF/VEGFR(KDR,Flt-1)before and after chemtheropy with S-P immhistochemical staining.Their relations to the clinical features were evaluated.Results The expressions of VEGF,Flt-1,KDR were significantly higher in newly diagnosed children with AL than those of control group.They were significantly higher in children with acute myeloid leukemia(AML) than in children with ALL.The expressions of VEGF,Flt-1,KDR in remission chidren after chemotheropy were significantly lower than before chemotheropy.There was a positive correlation of the percentage of bone marrow blasts with VEGF expression in children with AL.There was also a positive correlation of the percentage of leukemic cell in blood rountine with VEGF expression.For the untreated group of children,no correlation was found between expressions of VEGF,Flt-1,KDR and age,sex,extramedullary infiltration.Conclusions Expression levels of VEGF,Flt-1,KDR in bone marrow of children with AL increases.VEGF/VEGFR may play an important role in process of chidhood AL.