| Summary: | 碩士 === 國立臺灣大學 === 臨床醫學研究所 === 95 === BACKGROUD. Concerted expression of angiopoietins, their receptor Tie2 and vascular endothelial growth factor (VEGF) family plays an essential role in normal and pathologic angiogenesis, but its clinical implication in AML remained unclear. .
METHODS. We investigated the RNA expression of genes encoding angiopoietin-1 (Ang-1), angiopoietin-2 (Ang-2), the receptor Tie2, VEGF-A and VEGF-C by real-time quantitative polymerase chain reaction (RQ-PCR) in a cohort of 126 patients with newly diagnosed de novo AML and 22 normal marrow donors. The results were correlated with clinical features and outcome of the patients.
RESULTS. Expression of Ang-1, Ang-2 and VEGF-A was significantly higher and that of VEGF-C was lower in AML patients than in normal controls. Only unfavorable karyotype and higher expression of Ang-2, but not other angiogenic factors, were independent prognostic factors for overall survival by multivariate analysis, with a hazard ratio of 2.19 (95%CI, 1.27-3.77, P=0.005) and 2.05 (95%CI, 1.20-3.52, P=0.009), respectively. The prognostic significance of Ang-2 expression was more obvious in the subgroup of patients with intermediate-risk cytogenetics (P=0.004). Subgroup analysis showed that Ang-2 expression had prognostic impact on patients with low (but not high) Ang-1 or Tie2 levels, and on patients with high (but not low) VEGF-A or VEGF-C levels.
CONCLUSIONS. These results provide evidence that high pre-treated levels of Ang-2 in the bone marrow indicate an unfavorable prognosis in AML.
|
|---|
