急性白血病患者中ICAM-1和VCAM-1的表达及意义

Expression and significance of intercelluar adhesion molecule-1 and vascular cell adhesion molecule-1 in patients with acute leukemia

目的探讨细胞间黏附分子1(ICAM-1)和血管细胞间黏附分子1(VCAM-1)在急性白血病(AL)中的表达及临床意义。方法39例初诊AL患者,其中27例经治疗后达完全缓解(CR)。采用逆转录-PCR法检测AL骨髓单个核细胞ICAM-1和VCAM-1的 mRNA表达水平。对照组12例均为骨髓像正常的门诊患者。结果ICAM-1和VCAM-1水平在初诊AL者明显高于CR组及对照组(P<0.01),且CR组和对照组之间无显著差异(P>0.05);高白细胞(WBC>100×109/L)组和死亡组的ICAM-1和VCAM-1水平明显增高(P<0.05)。髓外浸润组仅ICAM-1高于非髓外浸润组(P<0.01);非淋巴细胞AL(ANLL)具有良好核型者ICAM-1水平低于其他患者(P<0.05)。结论AL表达ICAM-1和VCAM-1明显增高,其检测对疗效及预后判断有重要意义。

Objective To investigate the expression and its significance of intercellular adhesion molecule-1 （ICAM-1） and vascular cell adhesion molecule-1 （VCAM-1） in acute leukemia （AL）. Methods The expressions of ICAM-1 and VCAM-1 were detected by reverse transcriptase-PCR analysis in bone marrow mononuclear cells of 39 untreated AL. Twenty-seven of 39 patients achieved complete remission （CR） after chemotherapy. Twelve out-patients with normal bone marrow were taken as the controls. Results The expressions of ICAM-1 and VCAM-1 in untreated group were much higher than those in the control and CR group （P〈0. 01）, which were not significantly different between CR group and control group （P〈0. 05）. Elevated levels of ICAM-1 and VCAM-1 were seen in hyperleukocyte group （WBC〉100 10^9/L） and death group（P〈0. 05）. The untreated patients with extramedullary invasion showed higher expression of ICAM-1, but not VCAM-1, than those without extramedullary invasion （P〈0.01 ）. The untreated ANLL patients with good prognostic karyotype showed lower expression of ICAM-1 than other patients （P〈0. 05）. Conclusion The expressions of ICAM-1 and VCAM-1 were abnormal in AL, which may be taken as a useful marker for evaluating the therapeutic efficacy and prognosis.