血管内皮生长因子在颅内动脉瘤中的表达

Expression of vascular endothelial growth factor in intracranial aneurysms

目的 探讨血管内皮生长因子(vascular endothelial growth factor,VEGF)在脑动脉瘤中的表达情况与临床特征之间是否存在相关性,为动脉瘤的病因研究提供线索。方法 脑动脉瘤标本18例,将3例尸检的Willis动脉环血管标本作为对照,切片做VEGF和碱性成纤维细胞生长因子(basic fibroblastgrowth factor,bFGF)的免疫组化染色。光镜下观察,记录染色部位,并对染色的强度进行分级,计算阳性指数。结合病变特点和临床特征,统计分析VEGF在动脉瘤中的表达与动脉瘤的大小、患者年龄、Hunt-Hess分级以及和bFGF表达的关系。结果 3例Willis动脉环均无VEGF和bFGF染色,而动脉瘤的VEGF和bFGF染色阳性率分别为88.9％(16／18)和55.5％(10／18)。经统计学分析,动脉瘤壁的中膜和外膜VEGF表达阳性率较内膜阳性率高(X2=9.94,P<0.05);VEGF在动脉瘤壁的表达与患者的年龄、动脉瘤的大小、Hunt-Hess分级无关(P>0.05)。VEGF较bFGF的表达阳性率高(X2=4.985,P<0.05)。结论 VEGF可能与动脉瘤的增长和结构的维持有关。动脉瘤的发生、生长和破裂是个复杂的过程,VEGF可能是主要的影响因素之一。

Objective To explore the expression of VEGF in intracranial aneurysms and to investigate the relationship between VEGF expression and clinical features. This study also hope to obtain useful informations for better understanding of the etiology and prognosis of intracranial aneurysms. Methods 18 aneurysmal specimens were obtained in the operation during 1993 to 2002, and 3 specimens of Willis' circle arteries were obtained from autopsy in 1999 at the same hospital and served as control. VEGF and bFGF(basic fibroblast growth factor) expression were performed on 5μm paraffin embeded section by immunohistochemistry. All the stained sections were observed under the microscope recording the positive site and intensity. SPSS 10. 0 statistical software was used to analyze the relationship between VEGF positive index (PI) and some clinical features, including patient'sage, Hunt-Hess grading, aneurysmal size, and bFGF expression. Results Three specimens of Willis circle vessels showed negative immunohistochemistry staining while the aneurysms had a positive rate of 89% (25/28). Media and adventitia layers of the aneurysms had significantly higher positive rate than endothelium layer (x2 =9.94, P<0.05); There was no correlation between VEGF expression and patient's age, aneurysm size and Hunt-Hess grading. The positive rate of VEGF expression was significantly higher than that of bFGF expression in all cases of aneurysms (x2=4.985, P<0.05). Conclusion VEGF may play an effective role in growth and maintenance of intracranial aneurysms. The development, progress and rupture of aneurysms is a complicated process. VEGF may be one of the main responsible factors.