目的：研究喉鳞癌患者外周血中循环CD45low CD34+ KDR+内皮祖细胞（endothelial progenitor cells，EPCs）的水平及其与喉鳞癌发生、发展的相关性。方法：收集2010年2月至2011年2月20例喉鳞癌患者外周血标本，10例健康志愿者外周血作为对照。流式细胞术检测CD45lowCD34+KDR+ EPCs占外周血CD34+造血干细胞或外周血淋巴细胞的比例，实时定量PCR检测PBMC中KDR mRNA和CD133 mRNA的表达水平，ELISA与Griess法分别检测血清中VEGF和NO的水平。结果：临床Ⅱ期～Ⅳ期的喉鳞癌患者外周血CD45lowCD34+KDR+ EPCs占CD34+造血干细胞的比例和占淋巴细胞的比例均较健康对照组明显升高\[（55.4±11.4）% vs（21.0±5.8）%，P<0.05；（1.27±0.25） vs（0.25±0.09），P<0.05\]。临床Ⅱ期～Ⅳ期喉鳞癌患者PBMC中KDR mRNA和CD133 mRNA的表达水平及血清中VEGF水平均明显高于健康对照组（P<0.05），NO水平没有明显差异；而临床Ⅰ期的喉鳞癌患者CD45lowCD34+KDR+EPCs比例、KDR mRNA和CD133 mRNA表达以及VEGF水平与健康对照组相比无差异。结论：晚期喉鳞癌患者外周血循环CD45lowCD34+KDR+ EPC和血清中VEGF水平均明显升高，可能与肿瘤的发生有关。

Objective: To study the ratio of circulating CD45low CD34+ KDR+ endothelial progenitor cells (EPCs) in peripheral blood of laryngeal squamous carcinoma patients, and to investigate its relationship with the development and progress of laryngeal squamous carcinoma. Methods: Blood samples from 20 laryngeal squamous carcinoma patients, who were diagnosed from Feb. 2010 to Feb. 2011, and 10 healthy volunteers were included in the present study. The ratio of CD45low CD34+ KDR+ EPCs in peripheral CD34+ haemopoietic stem cells or peripheral lymphocytes was detected by flow cytometry, the expressions of KDR and CD133 mRNA in PBMC were examined by real-time RT-PCR, and the levels of VEGF and NO in plasma were assayed by ELISA and Griess assay, respectively. Results: The ratios of CD45low CD34+ KDR+EPCs in both peripheral CD34+ haemopoietic stem cells and peripheral lymphocytes of laryngeal squamous carcinoma patients in stage Ⅱ-stage Ⅳ were significantly higher than those in healthy volunteers (\[55.4±11.4\]% vs \[21.0±5.8\]%，P<0.05; \[1.27±0.25\] vs \[0.25±0.09\], P<0.05). The expressions of KDR and CD133 mRNA and the level of plasma VEGF in laryngeal squamous carcinoma patients of stage Ⅱ-stage Ⅳ were significantly higher than those in healthy volunteers (P<0.05), but there was no significant difference in NO level. The ratio of CD45low CD34+ KDR+EPCs, the expression of KDR mRNA and CD133 mRNA, and the level of plasma VEGF in laryngeal squamous carcinoma patients of stageⅠwere similar to those in healthy volunteers. Conclusion: The ratio of circulating CD45low CD34+ KDR+ EPCs in peripheral blood and serum VEGF in advanced laryngeal squamous carcinoma patients are increased, which may be related to the development of tumors.

上海卫生局青年科技基金项目（No.2007Y43）