Prognostic value of bone marrow angiogenesis in multiple myeloma.
Prognostic value of bone marrow angiogenesis in multiple myeloma.
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发表时间：
2000-08
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通讯作者：
S. Rajkumar;T. Leong;P. Roche;R. Fonseca;A. Dispenzieri;M. Lacy;J. Lust;T. Witzig;R. Kyle;M. Gertz;P. Greipp
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作者：
S. Rajkumar;T. Leong;P. Roche;R. Fonseca;A. Dispenzieri;M. Lacy;J. Lust;T. Witzig;R. Kyle;M. Gertz;P. Greipp
我们研究了血管生成分级和微血管密度估计在新诊断的多发性骨髓瘤中的预后价值。75例新诊断的骨髓瘤患者在梅奥诊所接受东部合作肿瘤方案E9486和组间研究0141(S9321)的治疗。用免疫组织化学方法检测骨髓微血管中von Willebrand因子的表达。采用盲法测定微血管密度和血管生成分级。微血管密度与浆细胞标记指数Rho0.42呈正相关(P<0.01)。而中、高度血管生成的患者中，47%的标记指数较高(P=0.02)。高、中、低级别血管生成患者的总生存期有显著差异，中位生存期分别为2年、4年和4.4年(P=0.02)。同样，微血管密度<50/x400视野的患者与微血管密度<50/视野的患者相比，生存率较差，中位生存期分别为2.6年和5.1年(P=0.004)。血管生成分级和微血管密度之间有很强的相关性(P<；0.001)。我们得出结论，在新诊断的骨髓瘤中，骨髓血管生成是一个预后不良的预测因子。血管生成与浆细胞标记指数相关，而与骨髓浆细胞百分比无关。血管生成的一个简单的视觉分级是微血管密度估计的有效替代方法。
We studied the prognostic value of angiogenesis grading and microvessel density estimation in newly diagnosed multiple myeloma. Seventy-five patients with newly diagnosed myeloma, treated on Eastern Cooperative Oncology Protocol E9486 and Intergroup study 0141 (S9321) at the Mayo Clinic, were studied. Bone marrow microvessels were examined using immunohistochemical staining for von Willebrand factor. Determination of microvessel density and angiogenesis grading was done in a blinded manner. There was a strong correlation between microvessel density and the plasma cell labeling index, rho 0.42, P 1%). In contrast, 47% of patients with intermediate or high-grade angiogenesis had high labeling indices (P = 0.02). Overall survival was significantly different among those with high-, intermediate-, and low-grade angiogenesis, with median times of 2, 4, and 4.4 years, respectively (P = 0.02). Similarly, patients with microvessel density >50/x400 field had poorer survival compared with those with 50 or fewer microvessels/field, median survival 2.6 versus 5.1 years, respectively (P = 0.004). There was a strong association between angiogenesis grade and microvessel density (P < 0.001). We conclude that bone marrow angiogenesis is a predictor of poor survival in newly diagnosed myeloma. Angiogenesis is correlated with the plasma cell labeling index but not the bone marrow plasma cell percentage. A simple visual grading of angiogenesis is an efficient alternative to microvessel density estimation.