摘要
目的 :探讨骨髓中血管生成在急性髓性白血病的发病及预后的作用。方法 :应用免疫组化的方法检测 2 8例初治的急性髓性白血病 (AML)患者的骨髓活检标本治疗前后血管内皮生长因子 (VEGF)及其受体Flt 1、KDR、微血管密度 (MVD)的变化 ,并与对照组进行比较。结果 :初治AML患者骨髓病理组织中KDR、VEGF和MVD的表达高于对照组 (P <0 .0 5 ) ,内皮细胞出芽现象广泛存在 ,生成的微血管无明显血管管腔形成 ,而正常骨髓组织的微血管管腔大而直 ;VEGF及KDR与MVD呈正相关 ;化疗后完全缓解组骨髓组织的VEGF、KDR阳性率及MVD明显下降 (P<0 .0 5 ) ,治疗后未完全缓解组的VEGF、KDR阳性率及MVD与治疗前无显著性下降 (P >0 .0 5 ) ;Kaplan Meier分析显示治疗前VEGF阳性组的生存时间大于VEGF阴性组 (P <0 .0 5 ) ,但治疗前KDR、MVD的表达情况与生存时间无相关性。结论 :AML骨髓组织中存在血管生成 ,VEGF KDR信号传导通路在急性白血病血管新生中起主要作用 。
Objection:To explore the role of angiogenesis in marrow of acute myeloid leukemia(AML).Methods:Bone marrow biopsies were done in 28 patients with newly diagnosed untreated AML. Microvessel density (MVD),vascular endothelial growth factor(VEGF)and its receptors KDR,and Flt were examined by immunohistochemical staining before and after induction chemotherapy.Results:The expression of VEGF,KDR and MVD were significantly higher in initial diagnosed AML patients than that in control group. Endothelial cell sprouts and microvessel without visible lumina prevailed in AML patients, contrasting with the bigger and well shaped microvessel in the controls. There was positive correlation between VEGF,KDR and MVD. The positive rate of VEGF,KDR and MVD were reduced to normal level in patients who achieved a complete remission( P <0.05),while there was no significantly reduced in patients who did not achieved complete remission( P >0.05).Kaplan Meier analysis showed that the survive time of VEGF negative group was longer than VEGF positive group ( P <0.05)while the pre treatment MVD,VEGF had no correlation with survival time.Conclusion:There is remarkable angiogenesis in AML and VEGF/KDR signaling pathway that takes important role in pathological angiogenesis.VEGF could be used as a prognostic factor in AML.
出处
《江西医学院学报》
2003年第1期5-9,F002,共6页
Acta Academiae Medicinae Jiangxi
关键词
血管内皮生长因子
血管内皮生长因子受体
急性白血病
vascular endothelial growth factor
vascular endothelial growth factor receptor
acute myeloid leukemia
