血管内皮生长因子在脑动静脉畸形中的表达

Expression of vascular endothelial growth factor in cerebral arteriovenous malformations

目的探讨血管内皮生长因子(VEGF)在脑动静脉畸形(AVM)中的表达与临床特征之间是否存在相关关系,为研究AVM的发病机制提供线索,为寻找更好的治疗方法和判断预后提供依据。方法脑AVM标本28例,4例因内减压而切除的相对正常脑组织中的血管作对照。切片行VEGF的免疫组化染色,光镜下观察,记录染色的部位,并对染色的强度进行分级,计算阳性指数。分析VEGF在AVM中的表达与病变的大小、患者年龄、Spetzler分级的关系。结果4例正常脑组织中的血管壁均无VEGF染色,而AVM的血管壁VEGF染色阳性率为89%(25/28)。经统计学分析,动脉和静脉均有明显的VEGF染色,而且静脉比动脉的VEGF表达阳性率高(χ2=4.77,P<0.05)。VEGF在AVM中的表达与患者的年龄、AVM的大小、Spetzler分级无关(P>0.05)。结论在AVM中VEGF可能与静脉壁动脉化改变有关。AVM的生长和破裂是复杂的过程,VEGF是主要的但不是惟一的影响因素。

Objective To study the correlation between the expression of vascular endothelial growth factor （VEGF） in cerebral arterlovenous malformations （CAVM） and clinical characteristics and to provide clues for study of AVM development and basis for treatment and prognosis. Methods Surgical specimens from 28 patients undergoing CAVM resection were studied and the blood vessels from normal brain tissues in 4 patients undergoing resection clue to internal decompression were taken as controls. All specimens were immunohistochemically stained for VEGF, which were observed under light microscopy and recorded. The strength of staining was graded and the positive index was counted. The relationship between VEGF expression in AVM and lesion size ,age as well as Spetzler classification was analyzed. Results The blood vessel wall in 4 normal brain tissues was not VEGF stained but the positive rate for VEGF was 89% （25/28） in blood vessel wall of AVM. Statistically obvious VEGF staining was found in artery and vein and the positive expression rate of VEGF was higher in vein than in artery （ χ^2 = 4.77, P 〈 0.05 ）. VEGF expression in AVM was not associated with age, AVM size, and Spetzler classification （ P 〉 0.05 ）. Conclusion VEGF may contribute to the arterization of venous wall in AVM. AVM growth and rupture is a complicated process and VEGF is the major but not the only affective factor.