论文部分内容阅读
目的:探讨急性早幼粒细胞白血病(acute promyelocytic leukemia,APL)患者治疗前后循环内皮细胞(circulating endothelial cells,CECs)数量、表面抗原及生物学特性的变化,并分析其与临床指标的关系。方法:免疫磁珠结合三色流式细胞仪分选计数APL患者初诊及治疗后CECs的数量;免疫荧光染色检测APL患者初诊及治疗后CECs表面CD146、CD31、CD144、VEGFR-2、CD45及CD133的表达水平。体外培养CECs进行血管生成实验及细胞集落形成率的测定。结果:APL患者CECs在外周血白细胞>10×10~9/L及CD34阳性患者中数量明显增多(P<0.05),高危、低危及中危3组患者的CECs数量也呈现明显的差异(P<0.05)。32例APL患者诱导化疗后均获得完全缓解,治疗后CECs数量及其表面CD133表达水平均明显下降(P<0.05)。同时治疗后APL患者CECs体外形成血管数目及细胞的集落形成率均明显减少(P<0.05)。APL患者CECs数量治疗后/治疗前的比值与As_2O_3治疗1周后的尿砷浓度呈现明显负相关性(P<0.05)。结论:精确计数并深入了解CECs生物学特性可能有助于评价APL的预后及设计治疗策略。
Objective: To investigate the changes of the number, surface antigen and biological characteristics of circulating endothelial cells (CECs) in patients with acute promyelocytic leukemia (APL) before and after treatment, and to analyze their relationship with clinical parameters. Methods: The numbers of newly diagnosed and untreated CECs in APL patients were counted by immunomagnetic bead sorting and flow cytometry. The expression of CD146, CD31, CD144, VEGFR-2, CD45 and CD133 on the surface of CECs were detected by immunofluorescence staining The level of expression. CECs were cultured in vitro for angiogenesis and colony formation assay. Results: The number of CECs in APL patients was significantly higher than that in peripheral blood leukocytes> 10 × 10 ~ 9 / L and CD34 (P <0.05), while the numbers of CECs in high risk, low risk and intermediate risk groups were also significantly different (P <0.05). All 32 APL patients achieved complete remission after induction chemotherapy, and the number of CECs and the expression of CD133 on the surface were significantly decreased after treatment (P <0.05). After treatment, the number of vascular endothelial cells and the colony formation rate of CECs in APL patients were significantly decreased (P <0.05). There was a significant negative correlation between the number of CECs in patients with APL after treatment / before treatment and the concentration of arsenic in urine after one week of As2O3 treatment (P <0.05). Conclusion: Accurate counting and in-depth understanding of the biological characteristics of CECs may be helpful in evaluating the prognosis of APL and designing treatment strategies.