Department of Pathology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
Ann Hematol. 2010 Aug;89(8):789-94. doi: 10.1007/s00277-010-0919-z. Epub 2010 Feb 23.
Increased angiogenesis has been found to be an adverse prognostic factor in solid tumors but evidences show that angiogenesis also plays an important role in hematological malignancies including multiple myeloma (MM). In this report we studied the various angiogenesis parameters like microvessel density (MVD) and total vascular area (TVA), on bone marrow biopsies in 50 newly diagnosed cases of MM. The aim was to study bone marrow angiogenesis in MM using light microscopy (MVD-A) and computerized image analyzer (MVD-B and TVA) and correlate it with clinical features, laboratory findings, histological features, and response to treatment on follow-up. Bone marrow biopsies of test cases (n = 50) were immunohistochemically stained with CD34 for visualization of microvessels. MVD-A (range 8-80; mean 50.4; SD 17.5), MVD-B (5.2-33.2; mean 16.3; SD 5.1), and TVA in percentage (range 0.42-7.20; mean 2.8; SD 1.5) were measured. Ten age- and sex-matched controls were studied and their parameters were taken as grade I. There was a significant correlation between these angiogenesis parameters (MVD-A vs MVD-B, Pearson's correlation coefficient (pcc) = 0.724; MVD-A vs TVA, pcc = 0.370; MVD-B vs TVA, pcc = 0.406). The angiogenesis was significantly higher in cases as compared to controls. Patients with residual disease had a higher MVD as compared to the complete responders. High tumor burden and diffuse pattern of infiltration were also associated with grade III MVD and TVA. Hence, it can be concluded that angiogenesis correlates with other histological features associated with prognosis and is also a good predictor for complete response in patients with multiple myeloma.
在实体瘤中，血管生成增加被认为是一个不良的预后因素，但有证据表明，血管生成在包括多发性骨髓瘤（MM）在内的血液恶性肿瘤中也起着重要作用。在本报告中，我们研究了 50 例新诊断的 MM 患者骨髓活检中的各种血管生成参数，如微血管密度（MVD）和总血管面积（TVA）。目的是使用光学显微镜（MVD-A）和计算机图像分析（MVD-B 和 TVA）研究 MM 中的骨髓血管生成，并将其与临床特征、实验室发现、组织学特征和随访中的治疗反应相关联。用 CD34 对测试病例（n = 50）的骨髓活检进行免疫组织化学染色，以显示微血管。MVD-A（范围 8-80；平均值 50.4；标准差 17.5）、MVD-B（5.2-33.2；平均值 16.3；标准差 5.1）和 TVA 的百分比（范围 0.42-7.20；平均值 2.8；标准差 1.5）。研究了 10 名年龄和性别匹配的对照者，并将其参数作为 1 级。这些血管生成参数之间存在显著相关性（MVD-A 与 MVD-B，Pearson 相关系数（pcc）= 0.724；MVD-A 与 TVA，pcc = 0.370；MVD-B 与 TVA，pcc = 0.406）。与对照组相比，病例中的血管生成明显更高。与完全缓解者相比，有残留疾病的患者的 MVD 更高。高肿瘤负荷和弥漫性浸润模式也与 III 级 MVD 和 TVA 相关。因此，可以得出结论，血管生成与其他与预后相关的组织学特征相关，并且也是多发性骨髓瘤患者完全缓解的良好预测指标。
