骨髓增生异常综合征与血管新生

MYEL ODYSPL ASTIC SYNDROME AND VASCUL ARIZATION

目的 :探讨血管新生及其调控机制在骨髓异常增生综合征 (MDS)发病机制、病情进展及预后判断中的价值。方法 :将 31例 MDS患者根据病情分成两组 ,将难治性贫血 (RA)、环状铁粒幼细胞增多性难治性贫血伴 RAS分为 A组 ,原始细胞增多性难治性贫血 (RAEB)、转化型原始细胞增多性难治性贫血伴有 RAEB- t分为 B组。用 因子相关抗原和 CD34 单抗免疫组化染色的方法 ,观察患者骨髓微血管密度 (MVD)。用 EL ISA的方法测定患者血清血管内皮细胞生长因子 (VEGF)的浓度。结果 :MDS患者的 MVD普遍较正常对照组增高 ,但 A组与对照组相比 ,差异无显著性 (t=0 .37,P>0 .0 5 ) ;而 B组与对照组相比有显著性差异 (t=6 .98,P<0 .0 0 1)而且 A、B组相比亦有显著差异 (t=5 .37,P<0 .0 5 )。MDS患者 VEGF水平显示 :A、B两组均较对照组增高 ,且随着 MDS向急性白血病的转化而逐渐增高 ,A组与对照组相比 ,差异有显著意义 (t=2 .86 ,P<0 .0 2 ) ,而 B组增高更为明显 ,B组与对照组相比差异有非常显著性 (t=6 .4 7,P<0 .0 0 1) ,B组较 A组增高 (t=3.4 86 ,P<0 .0 0 2 )。结论 :血管新生及其调控因素的异常在 MDS的发生。

Objective:To evaluate the vascularization and it` s regulation effect during the pathogenesis,developm ent and prognosis of the myelodysplastic syndrom e(MDS) .Methods:31pa- tients with MDS was divided into group A(RA,RAS,n=12 ) and group B(RAEB RAEBT n=19) . To observe the MVD of the MDS patient by the relating antigen and the im mune histochemistry staining of CD34 single clone antibody.To m easure the concentration of the serum vascular endothe- lial growth factor (VEGF) by EL IAS.Results:The level of MVD in MDS was usually higher than the normal control.There was notdifference between the group A and the control.(t=0 .37,P>0 .0 5 ) ,but there was significantdifference between the B and the control (t=6 .98,P<0 .0 0 1) ,and there was remarkable difference between group A and B(t=5 .37,P<0 .0 5 ) .The level of VEGF in MDS showed that group A and B was higher than the control,and it would increased gradually while the MDS is converted to the acute leukemia .There was obvious significance between group A and the control(t=2 .86 P<o.o2 ) .yet group B increased especially,there was much m ore significant dif- ference between group B and the control (t=6 ,4 7,P<0 .0 0 1) ,group B was higher than group A(t= 3.4 86 ,P<0 .0 0 2 ) .Conclusion:The vascularization and the regulation abnorm ality play an im portant role in the pathogenesis,developm ent and prognosis of the MDS .