Clinic of Hematology, Clinical Center of Vojvodina, Faculty of Medicine, Hajduk Veljkova 1-3, 21000 Novi Sad, Serbia.
Pathol Oncol Res. 2012 Jul;18(3):681-90. doi: 10.1007/s12253-012-9495-y. Epub 2012 Jan 24.
Angiogenesis has been implicated in the pathogenesis and prognosis of myelodysplastic syndrome (MDS). In this study, we investigated the relationship between microvessel density (MVD), vascular endothelial growth factor (VEGF) expression, common morphological and clinical factors, and survival in patients with MDS. We examined the MVD of paraffin-embedded bone marrow sections from 70 MDS patients and 31 controls. VEGF expression was determined in 50 patients and 20 controls. The median MVD in MDS patients was significantly higher than that in controls (p = 0.025), whereas there was no difference in VEGF expression between MDS patients and controls. In univariate analysis, increased MVD was associated with a shorter survival time (p = 0.023). However, in multivariate analysis, MVD was not an independent predictor of survival. The VEGF expression did not influence survival in univariate analysis. Survival was independently influenced by platelet count (p = 0.0073), cytogenetic risk category (p = 0.022), and transfusion dependence (p = 0.0073). Neither MVD nor VEGF expression were predictors for progression to acute myeloid leukemia in univariate analysis. Progression to acute myeloid leukemia was independently influenced only by the cytogenetic risk category (p = 0.022). This study confirmed increased MVD in MDS. It does not support an independent prognostic role of angiogenesis in MDS.
血管生成与骨髓增生异常综合征（MDS）的发病机制和预后有关。在这项研究中，我们研究了微血管密度（MVD）、血管内皮生长因子（VEGF）表达、常见形态学和临床因素与 MDS 患者生存之间的关系。我们检测了 70 例 MDS 患者和 31 例对照者石蜡包埋骨髓切片的 MVD。在 50 例患者和 20 例对照者中测定了 VEGF 表达。MDS 患者的中位 MVD 明显高于对照组（p=0.025），而 MDS 患者和对照组之间的 VEGF 表达没有差异。单因素分析显示，MVD 增加与生存时间缩短相关（p=0.023）。然而，多因素分析显示，MVD 不是生存的独立预测因素。VEGF 表达在单因素分析中对生存没有影响。在单因素分析中，血小板计数（p=0.0073）、细胞遗传学危险分类（p=0.022）和输血依赖（p=0.0073）对生存有独立影响。在单因素分析中，MVD 和 VEGF 表达都不是向急性髓系白血病进展的预测因素。向急性髓系白血病进展仅受细胞遗传学危险分类的独立影响（p=0.022）。这项研究证实 MDS 中存在 MVD 增加。它不支持血管生成在 MDS 中具有独立的预后作用。
