翼状胬肉组织中胶原纤维的病理学改变

Pathology change of the collagen fibers in pterygium

目的从病理学角度探讨翼状胬肉发生发展的机制。方法选择临床切除的复发及原发胬肉材料共50例,分头、体、尾部行苏木素-伊红染色及透射电镜观察。结果进行期胬肉表面复层鳞状上皮化生明显,杯状细胞数量多于静止期。浅层毛细血管较静止期胬肉增多,可见新生毛细血管内皮细胞异常连接,胶原纤维排列形态紊乱,成纤维细胞胞核见分裂相,胶原纤维及弹性纤维大量变性,可见中电子密度均质物及大量空泡变性胶原。空泡变性的成纤维细胞内可见线粒体肿胀,各种细胞器结构不清。结论翼状胬肉有明显的胶原纤维变性,研究提示氧自由基可能参与胬肉组织发生发展进程。

Objective To discuss the pathologic mechanism of pterygium. Methods Fifty specimens of pterygium were collected from patients with primary and recurrent pterygia. The microstructures of these pterygia were observed under the light microscope and transmission electron microscope (TEM). Results The metaplasia of the stratified squamous epithelia was obvious, and the goblet cells and the superficial capillaries were increased in active stage of pteiygia in comparison with one of quiescent stage. The abnormal connection of capillaries, disorder of collagen fibers and the splitting phase of fibroblast nuclear were seen,and a lot of collagen fibers and the elastic fibers demonstrated degeneration in these specimens. Mid-electric density substance and the vacuolation of the collagen fibers could also be seen. The structure of organelles in vacuolated fibroblasts was blurred,and mitochondrion edema was demonstrated. Conclusion Degeneration of collagen fibers in pterygium implies that oxygen-derived free radicals play some effects on the growth of pterygium.