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目的探讨血管内皮生长因子(vascular endothelial growth factor,VEGF)及其受体(vas-cular endothelial growth factor,VEGF)在儿童急性白血病骨髓中的表达,以及化疗前后的变化。方法53例儿童急性白血病患儿,其中急性淋巴细胞白血病(acute lymphocytic leukem ia,ALL)33例,急性髓系细胞白血病(acute myeloid leukem ia,AML)20例,对照组21例为骨髓象正常的非恶性血液病患儿。采用免疫组化方法检测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。结果VEGR、Flt-1、KDR在急性白血病患儿骨髓中表达水平高于对照组,在AML组中的表达高于ALL组。化疗后获得完全缓解(CR)的40例患儿,其VEGF、Flt-1、KDR的表达在化疗前后差异有显著性(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)。同时VEGF、KDR在儿童ALL中化疗后有明显的降低,但Flt-1无明显改变;VEGF、Flt-1、KDR在儿童AML中化疗后均有明显的降低。结论①VEGF、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。②VEGF、Flt-1、KDR在儿童AML中表达比ALL高。VEGF可以作为评价儿童急性白血病化疗反应的指标,同时说明ALL与AML可能具有不同的血管新生机制。
Objective To investigate the expression of vascular endothelial growth factor (VEGF) and its receptor (vas-cular endothelial growth factor, VEGF) in the bone marrow of children with acute leukemia and the changes before and after chemotherapy. Methods Totally 53 children with acute leukemia were enrolled in this study. Among them, 33 cases were acute lymphocytic leukemia (ALL), 20 cases were acute myeloid leukemia (AML) and 21 cases were normal bone marrow Children with non-hematologic malignancies. Immunohistochemistry was used to detect the expression of VEGF / VEGFR (including Flt-1 and KDR) in 53 children with acute leukemia before and after treatment and in control group. Results The expression of VEGR, Flt-1 and KDR in bone marrow of children with acute leukemia was higher than that of control group, and higher in AML group than in ALL group. The expression of VEGF, Flt-1 and KDR in 40 children with complete remission (CR) after chemotherapy was significantly different before and after chemotherapy (P <0.05). The levels of VEGF, Flt-1, KDR expression before and after chemotherapy was not significant (P> 0.05). At the same time VEGF, KDR in children with ALL after chemotherapy significantly reduced, but no significant change in Flt-1; VEGF, Flt-1, KDR in children with AML after chemotherapy were significantly reduced. Conclusion ① The expression of VEGF, Flt-1, KDR in children with acute leukemia increased. These results suggest that VEGF, Flt-1 and KDR play an important role in the pathogenesis of childhood acute leukemia. ② VEGF, Flt-1, KDR expression in children with AML higher than ALL. VEGF can be used as an indicator of response to chemotherapy in children with acute leukemia, at the same time that ALL and AML may have different mechanisms of angiogenesis.