摘要目的 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。

abstractsObjective 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.