目的：检测 2 型糖尿病患者眼房水中血管内皮生长因子（Vascular endothelial growth factor, VEGF）和白细胞介素-6（Interleukin-6, IL-6）的含量，并探讨其临床意义

方法：在白内障手术过程中获取 66 例 2 型糖尿病患者的房水，采用双抗体夹心酶联免疫吸附（ELISA）法测定 VEGF 和 IL-6 的含量。根据手术后散瞳眼底检查和眼底荧光素血管造影检查确定糖尿病视网膜病变的分期。实验组分为：无糖尿病视网膜病变组（NDR）21 例、单纯型糖尿病性视网膜病变组（BDR）26 例、增生型糖尿病性视网膜病变组（PDR）19 例，正常对照组为健康的老年性白内障患者 20 例。

结果：NDR 组、BDR 组、PDR 组的房水 VEGF 含量分别为（240.30 ± 26.15）pg/ml、（292.27 ± 58.91）pg/ml、（477.41 ± 91.01）pg/ml，IL-6 含量分别为（160.83 ± 33.41）pg/ml、（238.60 ± 62.23）pg/ml、（389.13 ± 90.35）pg/ml，对照组房水 VEGF 含量为（140.58 ± 26.27）pg/ml、IL-6 含量为（82.72 ± 21.53）pg/ml，对照组与实验组比较差异均有统计学意义（F = 113.67，P < 0.01；F = 106.53，P < 0.01）。实验组房水中的 VEGF 与 IL-6 含量有相关性（r = 0.995，P < 0.01）；糖尿病患者的病程与房水中 VEGF（r = 0.792，0.826，0.841 均 P < 0.01）、IL-6（r = 0.829，0.817，0.896 均 P < 0.01）含量有相关性。

结论：VEGF、IL-6 在糖尿病视网膜病变的形成过程中有重要作用，且两者之间有相关性。

Purpose: To explore the role of vascular endothelial growth factor (VEGF) and interleukin-6 (IL-6) in the aqueous humor in the pathogenesis of diabetic retinopathy (DR).

Methods: Aqueous humor samples were collected in type 2 diabetic patients during cataract surgery. The classification of DR was assigned based on the fundus examination and fluorescein angiography after cataract surgery. The experiment group included non-diabetic retinopathy (NDR, 21 cases), background diabetic retinopathy (BDR, 26 cases), and proliferative diabetic retinopathy (PDR, 19 cases). The control group was the healthy cataract patients (20 cases). The levels of VEGF and IL-6 in the aqueous humor were assessed using the ELISA technique.

Results: The level of VEGF in NDR, BDR, and PDR cases were (240.30 ± 26.15) pg/ml, (292.27 ± 58.91) pg/ml, and (477.41 ± 91.01) pg/ml, respectively. The level of IL-6 in NDR, BDR, and PDR cases were (160.83 ± 33.41) pg/ml, (238.60 ± 62.23) pg/ml, and (389.13 ± 90.35) pg/ml, respectively. The levels of VEGF and IL-6 in the aqueous humor from the control group were (140.58 ± 26.27) pg/ml, (82.72 ± 21.53) pg/ml. The levels of VEGF and IL-6 were significantly different in experiment and control groups (F = 113.67, P < 0.01; F = 106.53, P < 0.01). In the aqueous humor of diabetic patients increased significantly (P < 0.1). The levels of VEGF and IL-6 were significantly correlated with each other in the experiment group (r = 0.995, P < 0.01). The levels of VEGF (r = 0.792, 0.826, 0.841, P < 0.01) and IL-6 ((r = 0.829, 0.817, 0.896, P < 0.01) were also significantly correlated with the duration of DR.

Conclusion: VEGF and IL-6 play important roles in the development of DR. The levels of these two factors are correlated with each other in DR patients. 

目的：研究基质金属蛋白酶-2（Matrix metalloproteinase-2, MMP-2）、基质金属蛋白酶-9（Matrix metalloproteinase-9, MMP-9）和血管内皮生长因子（Vascular endothelial growth factor, VEGF）在视网膜母细胞瘤（Retinoblastoma, RB）中的表达及其与 RB 分化程度和视神经浸润的关系，探讨它们在 RB 浸润、转移过程中的作用和临床意义。

方法：采用免疫组化方法检测 40 例 RB 中 MMP-2、MMP-9 和 VEGF 的表达。

结果：40 例 RB 中 MMP-2、MMP-9 和 VEGF 的阳性表达率分别为 52.5%、57.5% 和 72.5%。未分化型 RB 中 MMP-2、MMP-9 和 VEGF 的阳性表达均高于分化型（P < 0.05）；有视神经浸润的 RB 中 MMP-2、MMP-9 和 VEGF 的阳性水平均高于无视神经浸润的 RB（P < 0.05）。RB 中 MMP-2、MMP-9 和 VEGF 的表达呈正相关关系（P < 0.05）。

结论：RB 中 MMP-2、MMP-9 和 VEGF 高表达与 RB 的浸润和转移相关，且 MMP-2、MMP-9 表达与 VEGF 表达存在相关性。联合检测 MMP-2、MMP-9 和 VEGF 的表达可作为反映 RB 浸润、转移潜能的生物学指标，有助于筛选转移高危病例及评价患者预后。

Purpose: To study the expression of matrix metalloproteinase-2 (MMP-2), matrix metalloproteinase-9 (MMP-9) and vascular endothelial growth factor (VEGF) in retinoblastoma (RB) and its relationship with the differentiation and optic nerve infiltration of RB. And to investigate the role of matrix metalloproteinase-2 (MMP-2), matrix metalloproteinase-9 (MMP-9) and VEGF in the infiltration and metastasis of RB and their clinical significance.

Methods: Immunohistochemical technique was used to detect the protein expression of MMP-2, MMP-9 and VEGF in 40 RB cases.

Results: The MMP-2, MMP-9 protein and VEGF protein expression were detected as positive in 52.5%, 57.5% and 72.5% of 40 RB cases respectively. The expression of MMP-2, MMP-9 and VEGF was significantly higher in the undifferentiated pattern than in the rosetted pattern (p < 0.05); and the expression of MMP-2, MMP-9 and VEGF was significantly higher in tumors with optic nerve invasion than in those without optic nerve invasion (p < 0.05). In RB, the expression of MMP-2, MMP-9 had a positive correlation with the expression of VEGF.

Conclusions: In RB, high expression of MMP-2, MMP-9 and VEGF is related to the invasion and metastasis of RB. The expression of MMP-2, MMP-9 is positively correlated with the expression of VEGF. The expression of MMP-2, MMP-9 and VEGF may act as a biological marker for the invasion and metastasis of RB. The method may help screen and identify the cases with high risk for metastasis and to predict the prognosis of patients.