急性早幼粒细胞白血病患者血清VEGF水平及临床相关研究

Serum level of VEGF in patients with acute promyelocytic leukemia and its correlation with clinical significance

目的探讨急性早幼粒细胞白血病(APL)患者血清血管内皮生长因子(VEGF)水平及其与临床特征的相关性,进而探讨VEGF对APL发病机制的作用和预后价值。方法双抗体夹心ELISA方法测定了22例APL患者治疗前血清VEGF水平,同时以15例健康成人作对照,观察其与APL临床特征的关系。结果①22例APL患者中,14例初发未治患者的血清VEGF平均水平(82.93±23.87)pg/mL,显著高于正常对照组(16.34±5.87)pg/mL(P<0.05),缓解期患者血清VEGF平均水平(20.00±4.38)pg/mL,与对照组无明显差异(P>0.05)。复发组(72.13±23.13)pg/mL,显著高于对照组(P<0.05),与初治组比较无明显差异(P>0.05);②相关性分析结果显示,初治患者血清VEGF水平与骨髓原始细胞比例呈显著正相关(r=0.721,P<0.01),与年龄、性别、APL亚型、近期疗效等临床指标无关。结论①APL患者血清VEGF水平升高,可能主要来自白血病细胞,反映APL患者体内肿瘤负荷,与白血病细胞生长、增殖有关;②血清VEGF水平与临床病情密切相关,可作为判断病情、估计预后、指导治疗的有效指标之一。

Objective To measure the serum levels of vascular endothelial growth factor（VEGF） in patients with acute promyelocytic leukemia （ APL） and study its correlation with clinical significance. Methods The serum levels of VEGF in 22 APL patients were detected by double-antibodies enzyme-linked immunosorbent assay （ ELISA）. Its correlation with clinical significance was observed. Fifteen healthy volunteers were regarded as controls. Results ①The average serum VEGF level of 14 initial APL patients was （82.93± 63.87）pg/mL,which was significantly higher than that of control group（P 〈0. 05）. In remission group, the average serum level was （20.00±4.38） pg/mL. There was no significant difference between remission group and control group （P 〉0.05）. Average serum level of relapsed patients was （72.13±23.13 ）pg/mL, which had no difference compared with that of initial group（ P 〉 0.05 ）. ②Correlation analysis showed that serum levels of VEGF in initial APL patients correlated significantly with the ratio of the blast cells of bone marrow（r =0. 721 ,P 〈0.01 ） positively. There was no correlation between the serum VEGF level and the clinical features such as age, sex, APL subtype and recent therapeutic effect. Conclusion ① Serum level of VEGF in APL was much higher than normal. It may be derived from leukemic cells and can represent tumor load of APL patients. It may play a role in the growth and proliferation of leukemic cells. ②The serum VEGF level of APL patients was significantly associated with clinical conditon, so it can be one of the important indicators for evaluating disease condition, assessing prognosis and directing treatment of APL patients.