儿童急性白血病患儿骨髓细胞中血管内皮生长因子及其受体的表达

目的探讨血管内皮生长因子(vascularendothelialgrowthfactor,VFGF)及其受体(vascu-larendothelialgrowthfactor-receptorVEOFR)在儿童急性白血病(acuteleukemia,AL)骨髓中的表达,分析其在化疗前后的变化。方法采用SP免疫组化方法检测53例急性白血病患儿治疗前后以及对照组骨髓中VEGF/VEGFR(包括Flt-1和KDR两种)的表达。光学显微镜下观察阳性细胞数,并判定其染色强度,计算二者之积,结果用任意单位(arbitraryunits,AU)值表示。统计分析采用t检验、方差分析、卡方检验,用SPSS11.0计算机软件进行分析。结果VEGF、FIt-1、KDR在急性白血病患儿骨髓中表达水平(AU=5.35±3.51,2.25±1.05,4.53±2.14)高于对照组(AU=3.36±1.85,1.12±0.85,1.90±1.12)(P<0.01).化疗后获得完全缓解(CR)的40例患儿,其VEGF、Fit-1、KDR的表达在化疗前为5.28±3.41,2.17±1.08和4.61±2.08,获CR后为3.02±1.78,1.18±0.96和2.50±1.15,差异有显著性(P<0.05)化疗后未获得CR患儿VEGF、Flt-1、KDR的表达在化疗前后无显著性(P>0.05)。骨髓中VEGF、Flt-1,KDR的表达水平在不同年龄、不同性别、有无髓外浸润无差异(P>0.05)。结论VEGF、Flt-1,KDR在儿童急性白血病中。表达增高,提示VEGF,Flt-1,KDR在儿童急性白血病的发生过程中起着重要作用。VEGF、Fit-1、KDR在儿童急性白血病化疗后均有明显的降低,提示VEGF可以作为评价儿童急性白血病化疗反应的指标。

The expressions of vascular endothelial growth factor (VEGF) and its receptors KDR and Flt - 1 in bone marrow of children with acute leukemia

Objective To investigate the expressions of VEGF/VEGFR in the bone marrow of children with acute leukemia,and to observe their changes before and after chemotherapy. Methods The bone marrows of 53 children with acute leukemia were collected to test the expressions of VEGF/VEGFR (KDR,Flt-1) by S-P immonohistochemical staining before and after chemotherapy. Samples were judged positive when the cytoplasm or membrane were dyed brown under microscope. The multiplication of positive cells and their dyeing density was viewed as arbitraryunits (AU). For comparing two groups t test and x2 test were used and processed by SPSS11.0 software. Results The expressions of VEGF,Flt-1 and KDR were significantly higher in newly diagnosed children with AL than those in control group. The expressions of VEGF,Flt-1,KDR in remission children after chemotherapy were significantly reduced than those before chemotherapy. There were no significant differences in expressions of VEGF,Flt-1,KDR with respect to age,sex,infiltration of CNS or degree of hepato-or/and splenomegaly. Conclusions Expressions of VEGF,Flt-1 and KDR were increased dramatically in the bone marrows of newly diagnosed children with AL,suggesting that VEGF/VEGFR may play an important role in the pathogenesis of childhood acute leukemia. In remission patients,the expressions of VEGF,Flt-1 and KDR were significantly decreased,indicating that VEGF could be a valuable prognostic marker for childhood acute leukemia.