急性淋巴细胞白血病患儿血浆血管内皮生长因子及组织因子的测定及其临床意义

Plasma concentrations of vascular endothelial growth factor and tissue factor in children with acute lymphoblastic leukemia

目的检测血浆血管内皮细胞生长因子(VEGF)和组织因子(TF)在急性淋巴细胞白血病(ALL)患儿中的含量变化并探讨其临床意义。方法用双抗体夹心酶联免疫吸附法检测33例ALL患儿血浆VEGF及TF在不同组别治疗前后含量的变化,并探讨两者之间的相关性及其临床意义。结果与正常对照组相比,ALL初治患儿在治疗前血浆VEGF,TF含量明显增高,两组差异有显著性(均P<0.01)。未缓解组患者化疗前血浆VEGF及TF的含量与缓解组化疗前和对照组相比明显升高,差异有显著性(P<0.05或P<0.01),未缓解组化疗后血浆VEGF和TF的含量无明显下降,与化疗前相比差异无显著性,但明显高于缓解组治疗后患者和对照组(均P<0.01)。血浆VEGF和TF在ALL患儿治疗前后低危、中危和高危组之间其差别具有显著性(均P<0.05)。高危组治疗后血浆VEGF和TF水平下降,与化疗前相比差异无显著性,但仍高于对照组(P<0.01)。ALL初治患儿治疗前血浆VEGF与TF含量的增加呈正相关(r=0.50,P<0.01)。结论VEGF,TF可作为了解ALL病情、观察疗效和判断预后的指标之一。

Objective To detect plasma concentrations of vascular endothelial cell growth factor （VEGF） and tissue factor （TF） in children with acute lymphoblastic leukemia （ALL） and explore their clinical significance in ALL. Methods Thirty-three children with newly diagnosed ALL, including 18 cases of low risk, 7 cases of moderate risk and 8 cases of high risk, were enrolled in this study. Twenty-five patients received a complete remission and 8 cases were in non- remission after conventional remission induction chemotherapy. Plasma concentrations of VEGF and TF in the patients were detected using ELISA before and after treatment. Sixteen healthy children served as normal control group. Results Plasma concentrations of VEGF and TF in ALL patients before treatment were significantly higher than those in normal controls （ P 〈 0.01 ）. Plasma concentrations of VEGF and TF in the non-remission group before treatment were significantly higher than those in the remission group （ P 〈0.05 ） and the control group （ P 〈0.01 ）. After treatment the plasma concentrations of VEGF and TF in the non-remission group were not significantly reduced and higher than those in the remission and the control groups （P 〈0.01 ）. There were significant differences in plasma concentrations of VEGF and TF among the low- risk, moderate-risk and high-risk groups before and after treatment （ P 〈 0.05 ）. Plasma concentrations of VEGF and TF in the high risk group were not significantly reduced after treatment and higher than those in the control group （ P 〈0.01 ）. A linear correlation was noted between plasma VEGF and TF concentrations in ALL patients before treatment （ r = 0.50, P 〈0.01 ）. Conclusions VEGF and TF play an important role in the development of ALL and may be useful to the evaluation of the severity and the outcome in ALL.