血浆VEGF蛋白含量与儿童急性白血病的临床意义

Clinical Significance of Serum VEGF in Acute Leukemia in Children

目的 检测急性白血病患儿外周静脉血浆中血管内皮生长因子(serumvascularendothelialgrowthfactor ,sVEGF)蛋白含量,分析sVEGF含量与儿童急性白血病(acuteleukemia,AL)不同类型、不同疾病状态及临床特征的关系,探讨sVEGF在AL的诊断、预后中的作用。方法 使用双抗体夹心酶联免疫吸附试验(sandwichenzyme linkedimmunoabsorbentassay ,ELISA)检测2 9例初发AL患儿、6例难治性AL患儿、2 0例缓解后AL患儿及2 0例健康儿童的sVEGF水平,采用t检验或t′检验比较各组之间的差异。检测值与相关临床因素分析采用相关回归分析及SAS统计软件分析。结果 初发组sVEGF水平明显高于缓解组、正常对照组,差别有统计学意义(t′=5 .15 ,7.2 3,P <0 .0 1) ;难治型AL患儿sVEGF水平均值明显高于初发组、缓解组(t′=2 .39,P <0 .0 5 ;t′=4 .94 ,Pρ<0 .0 1)及正常对照组(t′=5 .6 4 ,P <0 .0 1) ,差别具有统计学意义;缓解组与正常对照相比差别无统计学意义(t′=1.6 81,P >0 .0 5 )。此外,sVEGF水平与下列AL危险因素指标呈正相关或统计学意义:①化疗达缓解时间的长短(r=0 .80 3,P <0 .0 1) ;②发病时外周血白细胞数的高低(r =0 .75 6 4 ,P <0 .0 1) ;③髓外浸润(t=2 .15 3,P <0 .0 5 ) ;④血浆LDH水平(t =2 .4 97,P <0 .0 5 )。

Objective To explore the role of serum vascu la r endothelial growth factor (sVEGF) in the diagnosis and prognosis of acute leuk emia by detecting the concentration of sVEGF and analyzing its relation with the different leukemia subtypes,the disease condition and different clinical charac teristic.Methods ELISA was used to detect VEGF concentrations in the plasma from 35 bone marrow samples of acute leukemia without treatment (29 n ewly diagnosed,6 relapsed).Also 20 patients with complete remission(CR) as well as 20 normal children were detected likewise to analyze the relations between th e level of VEGF and some factors influencing prognosis of patients.Comparisons b etween two groups were made with t (or t′)test.The relationship between sVEGF a nd clinical prognosis factors were evaluated by linear regression analysis and s tatistical analysis system SAS. Results sVEGF level in newly diagnosed patients were sig nificantly higher than that of patients with CR and normal control (t′=5.15, 7.23,P<0.01);sVEGF level in refractory or relapsed patients were much higher than pre-treatment patients,patients with CR and normal control.(t′=2.39,P <0.05;t′= 4.94,t′=5.64,P<0.01).But there was no difference between CR a nd normal patients(t′=1.681,P>0.05).For the pre-treatment patients,sVEGF was positively correlated with the following risk factors:① time come to CR;② the number of peripheral white blood cells; ③ and lactate dehydrogenase infltr ated out of the bone marrow and ④ serum LDH level.No correlation was found betw een sVEGF and other clinical factors. Conclusion sVEGF level is related to the clinical change in child acute leukemia and it might be used as a prognostic indicator.