急性髓系白血病血管新生因子的表达及临床意义

Expression of Angiogenic Factors and Their Clinical Significances in Acute Myeloid Leukemia

背景与目的:研究证实,VEGF和bFGF表达水平与多发性骨髓瘤、非霍奇金淋巴瘤和慢性淋巴细胞白血病等疾病预后有关,本研究观察急性髓系白血病(AML)细胞血管内皮生长因子(VEGF)、碱性成纤维细胞生长因子(bFGF)及其受体的表达谱系、VEGF和bFGF的水平及与临床的关系。方法:RT-PCR方法检测VEGF、bFGF及其受体在转录水平的表达;ELISA检测血浆VEGF和bFGF水平,并分析其表达水平与临床的关系。结果:(1)107例初治AML患者VEGF、Flt和KDRmRNA阳性率分别56.1%、49.5%和2.8%;bFGF和其4个受体mRNA阳性率则分别为21.5%、35.5%、9.4%、35.5%和23.4%。(2)初治AML血浆VEGF水平为(154.75±109.98)pg/ml,明显高于健康对照组(99.91±41.87)pg/ml及AML-CR组(72.05±23.39)pg/ml(P<0.05);AML-CR组与正常对照组比无统计学差异(P>0.05)。初治AML患者血浆bFGF水平(10.00±6.70)pg/ml与正常对照(9.44±3.04)pg/ml及AML缓解患者(11.28±4.61)pg/ml比较无显著性差异(P>0.05)。2个疗程内获完全缓解患者血浆VEGF水平(124.05±76.57)pg/ml明显低于未获完全缓解者血浆VEGF水平(211.24±169.88)pg/ml(P<0.05)。用Kaplan-Meier生存分析可以评价生存期的86例初治AML患者,显示VEGF和bFGF水平与其生存期呈负相关。结论:AML细胞表达VEGF、bFGF及其?

BACKGROUND &OBJECTIVE: To investigate the expression of vascular e ndothelial growth factor (VEGF) &basic fibroblast growth factor (bFGF) in prima ry acute myeloid leukemia (AML) cells,and study plasma VEGF&bFGF concentration in patients with AML and the two factorsclinical significance. METHODS: VEGF& bFGF and their receptors mRNA expression were detected by RT-PCR; VEGF &bFGF p lasma level was analyzed by ELISA. RESULTS: In 107 AML patients,the positive mRN A expression rate of VEGF,KDR and Flt1 was 56.1%,49.5%,and 2.8%,respectively; for bFGF and FGFR1～4,the positive rate was 21.5%,35.5%,9.4%,35.5%and 23.4 %,respectively. VEGF concentration in AML (154.75±109.98)pg/ml was significant ly higher than that in AML-CR (72.05±23.39)pg/ml and the normal control (99.9 1±41.87)pg/ml (P< 0.05). Nevertheless,the level of bFGF had no significant d ifference among AML,AML-CR and the normal control. VEGF level (124.05±76.57) pg/ml in patients,who got complete remission (CR) after 2 cycles of chemotherapy ,was remarkably lower than that (211.243±169.88)pg/ml in patients without CR (P< 0.05). Furthermore,the higher the concentration of VEGF &bFGF,the shorter the survival was. CONCLUSION: VEGF&bFGF and their receptors mRNA in leukemic p atients could be expressed to some degree,and our investigation suggested VEGF &bFGF and their receptors probably be produced by autocrine or paracrin. Abnorm ally high level of VEGF may be a poor factor for chemotherapy and survival in AM L. The prognosis of patients with AML may be improved by treating VEGF and their receptors as therapy targets.