CAJ | 학술논문

目的探讨白血病患者骨髓中DLL4、HES1、VEGF-C及VEGFR-2的mRNA表达水平检测的临床意义，为白血病的诊治提供新的思路。方法选取白血病患者59例作为病例组，均根据临床表现、血象、骨髓象、细胞化学染色、细胞遗传学及流式细胞术检查确诊；对照组20例为营养性贫血患者。采用半定量反转录聚合酶链反应( RT-PCR)方法测定DLL4、HES1、VEGF-C、VEGFR-2 mRNA的含量。结果各组初发急性和慢性白血病患者骨髓中DLL4、HES1、VEGF-C、VEGFR-2mRNA的表达与对照组相比均显著升高(P＜0.05)。急性白血病缓解后DLL4、HES1、VEGFR-2的mRNA表达高于对照组( P= 0.041、0.016、0.047)。急性髓系白血病(AML)组DLL4与VEGFR-2、HES1与VEGF-C表达呈正相关(r= 0.424、0.472;P=0.030、0.014)；慢性淋巴细胞白血病(CLL)组HES1与VEGF-C表达呈正相关(r= 0.997，P=0.042)。急性白血病伴髓外浸润者VEGF-CmRNA的表达高于不伴髓外浸润者(P=0.022)。AML组VEGF-C mRNA的表达与原始细胞数呈正相关(r=0.315，P=0.024)。结论DLL4、HES1、VEGF-C及VEGFR-2在白血病发病中相互作用，促进白血病发展、转移及浸润，且这些因子在不同类型白血病及髓外浸润中的作用存在差异。
목적 탐토백혈병환자골수중DLL4、HES1、VEGF-C급VEGFR-2적mRNA표체수평검측적림상의의，위백혈병적진치제공신적사로。방법선취백혈병환자59례작위병례조，균근거림상표현、혈상、골수상、세포화학염색、세포유전학급류식세포술검사학진；대조조20례위영양성빈혈환자。채용반정량반전록취합매련반응( RT-PCR)방법측정DLL4、HES1、VEGF-C、VEGFR-2 mRNA적함량。결과각조초발급성화만성백혈병환자골수중DLL4、HES1、VEGF-C、VEGFR-2mRNA적표체여대조조상비균현저승고(P＜0.05)。급성백혈병완해후DLL4、HES1、VEGFR-2적mRNA표체고우대조조( P= 0.041、0.016、0.047)。급성수계백혈병(AML)조DLL4여VEGFR-2、HES1여VEGF-C표체정정상관(r= 0.424、0.472;P=0.030、0.014)；만성림파세포백혈병(CLL)조HES1여VEGF-C표체정정상관(r= 0.997，P=0.042)。급성백혈병반수외침윤자VEGF-CmRNA적표체고우불반수외침윤자(P=0.022)。AML조VEGF-C mRNA적표체여원시세포수정정상관(r=0.315，P=0.024)。결론DLL4、HES1、VEGF-C급VEGFR-2재백혈병발병중상호작용，촉진백혈병발전、전이급침윤，차저사인자재불동류형백혈병급수외침윤중적작용존재차이。
Objective To detect the expression level of DLL4, HES1, VEGF-C, VEGFR-2 mRNA in the bone marrow of leukemia patients and find a new treatment for leukemia with some new principles. Methods 59 patients of leukemia were collected and diagnosed on the basis of clinical manifestations, hemogram, bone marrow morphology, histochemical stain, cytogenetics and flow cytometry. 20 patients with nutritional anemia were chosen as the control group. The bone marrow aspiration were collected. Semiquantitative reverse transcription polymerase chain reaction (RT-PCR) was used to detect the levels of DLL4,HES1, VEGF-C, and VEGFR-2 mRNA. Results The levels of DLJL4, HES1, VEGF-C, VEGFR-2 mRNA in each group with newly diagnosed patients with acute and chronic leukemia were significantly higher than that in the control group (P ＜0.05). The levels of DLL4, HES1, VEGFR-2 mRNA in remission of acute leukemia were significantly higher than that in control group (P =0.041, 0.016, 0.047). In AML group DLL4 and VEGFR-2, HES1 and VEGF-C, mRNA expression were positively correlated (r =0.424, 0.472, P=0.030, 0.014). In CLL group the HES1 and VEGF-C mRNA expression was positively correlated (r =0.997, P =0.042). The levels of VEGF-C mRNA in acute leukemia patients with extramedullary infiltration were higher than that without extramedullary infiltration (P = 0.022). VEGF-C mRNA expression in AML group and the original cell counts were positively correlated (r = 0.315, P = 0.024). Conclusion These results suggested that the interaction of DLL4, HES1 and VECF-C, VEGFR-2 in the pathogenesis of leukemia may promote the development, metastasis and infiltration of leukemia, and these factors in different types of leukemia and extramedullary infiltration are different.