中枢神经系统白血病患儿脑脊液基质金属蛋白酶的表达及其与髓外浸润的关系

Expressions of Matrix Metalloproteinases in Pediatric Central Nervous System Leukemia and Their Roles Ext-ramedullary Infiltration

目的通过检测基质金属蛋白酶(MMPs)在急性白血病(AL)和中枢神经系统白血病(CNSL)患儿脑脊液中的表达情况及患儿确诊CNSL前后脑脊液MMPs的动态表达情况,探讨MMPs与儿童AL发生发展和髓外浸润的关系。方法采用明胶酶谱活性分析方法和图像分析系统检测22例未发生CNSL的AL患儿、18例CNSL患儿和3例非肿瘤非感染性疾病患儿脑脊液MMP-2、MMP-9的活性表达,并且动态检测CNSL患儿确诊CNSL前后脑脊液MMP-2、MMP-9的活性变化。结果MMP-2和MMP-9在对照组中的表达率为0,酶解活性水平分别为67.15±16.6和23.55±10.08;MMP-2和MMP-9在未发生CNSL的AL组中的表达率为31.8%,酶解活性水平分别为115.13±43.67和60.86±37.80,显著高于对照组(Pa<0.05);而MMP-2和MMP-9在发生CNSL的AL组中的表达率为100%,酶解活性水平分别为867.55±308.67和562.88±139.22,显著高于未发生CNSL组和对照组(Pa<0.05)。MMPs过量表达,特别是MMP-2在CNSL患儿脑脊液中高表达与白血病细胞浸润高度相关。结论MMP-2和MMP-9在AL患儿脑脊液中异常表达,可能参与了儿童AL的发生发展;通过检测MMP-2和MMP-9可间接反映白血病中枢神经系统浸润的发生和发展情况,并可对高危人群早期加强治疗,从而预防髓外浸润的发生,对指导临床诊断和治疗具有重要意义。

Objective To investigate the expressions of matrix metalloproteinase(MMP)-2 and MMP-9 in cerebrospinal fluid of acute leukemia(AL) and pediatric central nervous system leukemia(CNSL) and the dynamic changes of MMPs were detected in cerebrospinal fluid before and after CNSL was finally diagnosed.And their roles in extramedullary infiltration.Methods The expressions of MMP-2 and MMP-9 were detected by gelatin zymography in 22 cases of children suffering from AL without CNSL children,18 cases of CNSL children ...