骨髓增生异常综合征患者骨髓血管新生初步研究

The angiogenesis in the bone marrow of patients with myelodysplastic syndromes

目的 探讨骨髓增生异常综合征 ( MDS)患者骨髓是否存在血管新生 ,及其与患者临床特征的关系。方法 采用免疫组化法 (兔抗人凝血因子 相关抗原多克隆抗体 )标记了 38例 MDS、15例急性非淋巴细胞白血病( ANL L)和 15例正常人骨髓组织内血管内皮细胞。在光学显微镜下计数骨髓切片全片中微血管数 ,计算平均值 ,表达为微血管数 /× 4 0 0视野 ,并与患者临床特征进行相关性分析。结果 MDS组骨髓微血管数 ( 17± 2支 /× 4 0 0视野 )高于正常人对照组 ( 7± 2支 /× 4 0 0视野 ) ( P<0 .0 0 1) ,但低于 ANL L 组 ( 2 4± 4支 /× 4 0 0视野 ) ( P<0 .0 0 1) ,其中 MDS低危组与高危组骨髓微血管密度差异无显著性 ( P>0 .0 5 )。 MDS患者骨髓微血管数与骨髓原始细胞百分数、外周血白细胞、血红蛋白及血小板等差异无显著性 ( P>0 .0 5 )。结论 MDS患者骨髓存在明显的血管新生 ,为临床应用抗血管新生方法治疗 MDS提供了实验依据。

Objective To investigate the angiogenesis in the bone marrow of patients with myelodysplastic syndromes (MDS) Methods Bone marrow samples from 38 cases of MDS and 30 controls (15 cases of acute non lymphocytic leukemia and 15 cases of nomal volunteers) were studied Microvessels were counted by immunohistochemical identication of microvascular endothelial cells with anti human von Willebrand factor (vWF) throughout the entire core specimen in consecutive ×400 fields, and a mean count per field (/×400 field) was calculated Results The density of microvessels in the bone marrow of patients with MDS was higher than that of normal controls (17±2/×400 field vs 7±2/×400 field, P <0 001), but lower than that of acute non lymphocytic leukemia (24±4/×400 field) Microvessel counts had no difference between high risk group and lower risk group of MDS( P > 0 05) There was no correlation between microvessel counts and the percentage of blasts in the bone marrow Conclusion Angiogenesis may play a role in the pathophysiology of MDS and anti angiogenesis could constitue a novel strategy for the treatment of MDS