骨髓增生异常综合征造血细胞bcl-2 VEGF抗原表达及原位凋亡的研究  

Investigation of bcl-2 and VEGF Antigen Expression and In Situ Apoptosis of Hematopoietic Cells in Myelodysplastic Syndrome

作　　者：邱志祥[1] 李挺[2] 岑溪南[1] 许尉林[1] 任汉云[1] 

机构地区：[1]北京大学第一医院血液内科,北京市100034 [2]北京大学第一医院病理科,北京市100034

出　　处：《中国肿瘤临床》2012年第11期757-760,共4页Chinese Journal of Clinical Oncology

摘　　要：目的:研究骨髓增生异常综合征(MDS)bcl-2、VEGF抗原表达及造血细胞原位凋亡之间的关系,探讨MDS发病机理。方法:对MDS患者骨髓活检标本光镜下观察骨髓增生程度、各系造血细胞形态异常情况、不成熟前体细胞异常定位(ALJP)等组织病理学改变,免疫组织化学染色观测bcl-2及VEGF抗原的表达,TUNEL法检测造血细胞原位凋亡结果:13例患者骨髓均有不同程度的异常造血,异常造血主要累及的细胞系列不尽相同,RA、RAEB两组患者异常造血未见明显区别;有6例患者检出ALIP现象,其中RA 3例(3/8,37.50%),RAEB 3例(3/5,60.00%);VEGF阳性者占9例(9/13,69.23%),其中RA 6例(6/8,75.00%),RAEB 3例(3/5,60.00%);bcl-2阳性者占7例,其中RA4例(4/8,50.00%),RAEB 3例(3/5,60.00%);TUNEL检测13例患者均为阳性,检出ALIP现象者,其造血细胞发生原位调亡明显,而bcl-2、VEGF与TUNEL结果之间未见明显关联。结论:MDS患者均存在不同程度的细胞凋亡异常,而TUNEL法提供了简便、实用、敏感、快速特异的检测MDS细胞原位凋亡的方法结果初步显示MDS患者ALlP现象明显者其细胞凋亡也明显,提示调控MDS患者细胞凋亡和恶性克隆增殖可能是两种完全不同的机制。Objective： This work aims to investigate the relationship between bcl-2 and VEGF antigen expression and the in situ apoptosis of hematopoietic cells in myelodysplastic syndrome （ MDS ）, and to discuss the pathogenesis of MDS. Methods： Through bone marrow biopsy, the degree of bone marrow hyperplasia, morphological abnormity of hematopoietic cells, and histopathological change, called abnormal localization of immature precursor （ ALIP ） in light microscopy were observed. Immunohistochemistry was used to monitor the bcl-2 and VEGF antigen expressions. The in situ apoptosis of hematopoietic cells was detected using the terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling （ TUNEL ） method. Results： Different degrees of hematopoietic abnormalities were found in all 13 cases. The two groups with refractory anemia （ RA ） and refractory anemia with excess of blasts （ RAEB ） had no significant differences. ALIP was detected in 6 cases, of which 3 were RA （ 3/8, 37.50% ） and the other 3 were RAEB （ 3/5, 60.00% ）. Positive VEGF expression was observed in 9 cases, of which 6 were RA （ 6/8, 750% ） and the other 3 were RAEB （ 3/5, 60.00% ）. Positive bcl-2 expression was found in 7 cases, including 4 with RA （ 4/8, 50.00% ） and three with RAEB （ 3/5, 60% ）. All patients had positive TUNEL results. The patients with ALIP showed higher degrees of in situ apoptosis of hematopoietic cells. Conclusion： MDS patients have various degrees of abnormal apoptosis of hematopoietic cells. The TUNEL method is simple, practical, sensitive, convenient, and specific tool for detecting in situ cell apoptosis. However, the mechanisms in hematopoietic cell apoptosis and clonally malignant proliferation in MDS patients may differ zreatlv.

关 键 词：骨髓增生异常综合症bcl-2 VEGF原位凋亡TUNEL 

分 类 号：R551.3[医药卫生—血液循环系统疾病]