瘢痕性喉狭窄瘢痕组织中弹性纤维和胶原纤维分析

Analysis on Elastic Fibers and Collagen Fibers in Laryngeal Stricture Scar After Partial Laryngectomy

【目的】了解喉狭窄瘢痕组织中弹性纤维,Ⅰ型/Ⅲ型胶原纤维的含量和形态特征。【方法】喉部分切除术后瘢痕性喉狭窄13例患者的喉瘢痕组织为实验组及15例正常声带组织为对照组,分别进行苏木精鄄伊红染色,胶原纤维、弹性纤维复合染色,及Ⅰ、Ⅲ型胶原苦味酸鄄鄄天狼猩红染色,全自动图像分析系统下观察和计算。【结果】喉狭窄瘢痕组织中,细胞外基质排列紊乱,胶原纤维增多,弹性纤维含量(0.178±0.066)较正常声带中弹性纤维含量(0.374±0.055)明显减少(P<0.001);喉狭窄瘢痕组织Ⅰ型胶原的含量(0.382±0.199)较正常声带中Ⅰ型胶原含量(0.147±0.073)增加明显(P<0.05);喉狭窄瘢痕组织Ⅰ型/Ⅲ型比值(3.98±0.88)较正常声带组织(1.01±0.37)大(P<0.001)。【结论】弹性纤维及Ⅰ、Ⅲ型胶原纤维形态特征和含量改变可能是导致喉部分切除术后瘢痕性喉狭窄的病理基础。

Objective] To explore the significance of the change of elastic fibers, types Ⅰ and Ⅲ collagen fibers contents in the laryngeal stricture scar. [Methods] The laryngeal tissues were 13 human surgical specimens of laryngeal structure scar after partial laryngectomy and 15 human normal vocal folds. Collagen fibers and elastic fibers were observed by Van Gieson and Verhoeff compound staining respectively in laryngeal tissue sections. Types Ⅰ and collagen Ⅲ in laryngeal tissues were assessed by sirius red staining. [Results]In laryngeal stricture scar tissues, collagen fibers increased and elastic fibers obviously reduced in extracellular matrix. The density of elastic fibers in laryngeal stricture scar was 0.178±0.066 and that in the normal vocal fold was 0.374±0.055, there was significantly difference (P < 0.001); the density of type I collagen in laryngeal stricture scar was 0.382±0.199 and that in the normal vocal fold was 0.147±0.073, there was significantly difference (P< 0.05); the proportionality of typeⅠand Ⅲ collagen (3.98±0.88) was significantly higher than that (1.01±0.37) in the normal vocal fold (P < 0.001).[Conclusion]The change of the morphological features and contents in the elastic fibers, types Ⅰ and Ⅲ collagen fibers in the laryngeal structure scar, which may be the pathological foundation of laryngeal stricture after partial laryngectomy.