[急性早幼粒细胞白血病患者组织因子表达及止血分子标志物的研究]

[A study of tissue factor expression and hemostatic molecular markers in patients with acute promyelocytic leukemia].

作者信息

Wu F, Wang X, Zhao W, Wang H, Shen Z

机构信息

Shanghai Institute of Hematology, Ruijin Hospital, Shanghai Second Medical University, Shanghai 200025, China.

出版信息

Zhonghua Nei Ke Za Zhi. 2001 Jan;40(1):36-9.

PMID:11798557

Abstract

OBJECTIVES

To study the changes of tissue factor expression and hemostatic molecular markers in acute promyelocytic leukemia during all-trans retinoic acid (ATRA) or arsenic trioxide (AS(2)O(3)) treatment.

METHODS

The plasma level of tissue factor (TF), tissue factor pathway inhibitor(TFPI), thrombin antithrombin complex(TAT), plasmin antiplasmin complex(PAP), urokinase type plasminogen activator(u-PA), urokinase type plasminogen activator receptor(u-PAR) and the TF level of bone marrow blasts lysate were measured by ELISA. Transcription of TF mRNA was detected by RT-PCR.

RESULTS

The plasma levels of TF [(98.3 +/- 19.8) ng/L, (89.6 +/- 15.2) ng/L], TFPI [(94.4 +/- 37.0) mg/L, (93.5 +/- 36.4) mg/L], TAT [(21.9 +/- 9.6) microg/L, (18.2 +/- 9.7) microg/L[, PAP [(0.73 +/- 0.26) mg/L, (0.63 +/- 0.33) mg/L], u-PA [(0.63 +/- 0.23) microg/L, (0.57 +/- 0.01) microg/L] and u-PAR [(0.41 +/- 0.14) microg/L, (0.47 +/- 0.16) microg/L], the TF of bone marrow blasts lysate [(680.24 +/- 456.61) pg/10(7), (368.02 +/- 151.2) pg/10(7)] and transcription of mRNA were all remarkably elevated at the time of diagnosis. They all decreased after ATRA and AS(2)O(3) administration.

CONCLUSIONS

There is over expression of TF, activation of coagulation system and hyperfibrinolysis, in patients with acute promyelocytic leukemia, these can be ameliorated with clinical improvement. All-trans retinoic acid and arsenic trioxide down-regulate the expression of TF mRNA and decrease the TF contents in APL blasts. However, there is also high plasma level of TF and TAT indicating the existence of hypercoagulability after remission.

摘要

目的

研究全反式维甲酸（ATRA）或三氧化二砷（AS₂O₃）治疗急性早幼粒细胞白血病期间组织因子表达及止血分子标志物的变化。

方法

采用酶联免疫吸附测定法（ELISA）检测血浆中组织因子（TF）、组织因子途径抑制物（TFPI）、凝血酶 - 抗凝血酶复合物（TAT）、纤溶酶 - 抗纤溶酶复合物（PAP）、尿激酶型纤溶酶原激活物（u - PA）、尿激酶型纤溶酶原激活物受体（u - PAR）水平以及骨髓原始细胞裂解物中的TF水平。通过逆转录 - 聚合酶链反应（RT - PCR）检测TF mRNA的转录情况。

结果

诊断时血浆中TF[（98.3±19.8）ng/L，（89.6±15.2）ng/L]、TFPI[（94.4±37.0）mg/L，（93.5±36.4）mg/L]、TAT[（21.9±9.6）μg/L，（18.2±9.7）μg/L]、PAP[（0.73±0.26）mg/L，（0.63±0.33）mg/L]、u - PA[（0.63±0.23）μg/L，（0.57±0.01）μg/L]和u - PAR[（0.41±0.14）μg/L，（0.47±0.16）μg/L]水平，骨髓原始细胞裂解物中的TF[（680.24±456.61）pg/10⁷，（368.02±从151.2）pg/10⁷]及mRNA转录均显著升高。ATRA和AS₂O₃治疗后上述指标均下降。

结论

急性早幼粒细胞白血病患者存在TF过表达、凝血系统激活及纤溶亢进，随着临床病情改善这些情况可得到改善。全反式维甲酸和三氧化二砷可下调APL原始细胞中TF mRNA的表达并降低TF含量。然而，缓解后血浆中TF和TAT水平仍较高，提示存在高凝状态。（注：原文中“(368.02±从151.2)”疑似有误，已按原文翻译）