HRCT结合免疫组织化学对间质性肺疾病分期的初步研究

The Primary Study of HRCT with Immunohistochemistry to Stages of Interstitial Lung Disease

目的分析间质性肺疾病(ILD)的各期高分辨率CT(HRCT)表现及其与免疫病理学的关系。资料与方法19例经手术病理证实的ILD患者和7例正常对照者分别行HRCT扫描及免疫组织化学染色,分析其各期HRCT表现及与相关病理学的关系。结果ILD的各期HRCT表现有其相应病理改变。转化生长因子(TGF-β1)、碱性成纤维细胞生长因子(bFGF)、肿瘤坏死因子(TNF-α)在对照组、ILD早期组、中晚期组之间表达水平差异均有统计学意义(P<0.01)。TNF-α在早期组以(++)和(+++)为主,晚期以(+)和(++)为主。而TGF-β1和bFGF在早期组表达以(+)和(++)为主,晚期组以(++)和(+++)为主。bFGF、TGF-β1、TNF-α与HRCT征象之间相关性比较,χ2值分别为19.41、28.50、25.90(P<0.05)。结论HRCT是一种安全、准确、无创性的诊断ILD的手段,TGF-β1、bFGF、TNF-α在ILD发生、发展中起作用。TNF-α在早期急性肺泡炎期表达增强。而TGF-β1和bFGF在慢性纤维化期表达增强。

Objective To discuss the HRCT appearance of different stages in Interstitial Lung Disease （ILD）and its relation with immunohistochemistry. Materials and Methods 19 cases with ILD proved pathologically and 7 cases as control （DC） were performed HRCT scan and immunohistochemistry. The relation between HRCT appearance and immunohistochemistry was analyzed. Results There was well relation between HRCT and pathology in ILD. The positive rates of TGF-β1, bFGF, TNF-α had significant differences among disease control （ DC）, ILD early stage, ILD medium and late stage （P〈0.01）. TNF α expressed predominantly in （ ＋ ＋ ）/（ ＋ ＋ ＋ ） in early stage; but in （ ＋ ）/（ ＋ ＋ ） in late stage. However, TGF-β1 ,bFGF expressed predominantly in （ ＋ ）/（ ＋ ＋ ） in early stage; but in （ ＋ ＋ ）/（ ＋ ＋ ＋ ） in medium and late stage. The relation among TGF -β1 ,bFGF,TNF-α and HRCT findings, was χ^2 = 28.50,19.41 and 25.90 respectively （ P 〈 0.05 ）. Conclusion HRCT is a safe, sensitive and noninvasive diagnosis modality for ILDmeans. TGF-β1, bFGF, TNFa play roles in the occurring and developing stages of ILD. TNF-α express higher in early stage of acute alveolitis, but TGF-β1, bFGF express higher in the chronic fibrosis stage.