破裂颅内动脉瘤瘤壁核因子κB与血管内皮生长因子的表达

The study on the expressions of nuclear factor-kappa B and vascular endothelial growth factor in the wall of the intracranial aneurysm

目的探讨核因子κB(NF-κB)和血管内皮生长因子(VEGF)在破裂颅内动脉瘤瘤壁的表达及相关性,并观察两者与瘤壁血管重塑的关系。方法采用免疫组织化学方法对26例DSA和手术证实的颅内动脉瘤瘤壁标本的NF-κB和VEGF表达进行检测,10例因脑外伤手术切除颞极的颞叶皮层动脉血管标本作对照,光镜下观察各组染色结果并作统计学分析,同时行常规组织学检查观察瘤壁粥样硬化病变特点。结果动脉瘤组标本NF-κB和VEGF阳性表达分别为23/26和21/26,10例正常对照组标本中NF-κB和VEGF仅有微弱表达,差异有统计学意义(P<0·01);NF-κB和VEGF在颅内动脉瘤瘤壁中的表达均以内膜、中膜较高,外膜表达较少,两者在瘤壁中的表达有正相关性,相关系数为0·740。组织学检查发现瘤壁出现程度不同的动脉粥样硬化改变。结论动脉粥样硬化是颅内动脉瘤伴随的重要病理改变。NF-κB和VEGF在颅内动脉瘤发病和粥样硬化病变过程中可能发挥了重要的协同作用。

Objective To examine the expressions of NF-kappa B（NF-КB） and vascular endothelial growth factor （VEGF） in human intracranial aneurysm and explore their possible roles in remodeling of the vascular wall. Methods The diagnosis of 26 intracranial aneurysms were made by both DSA and operation and 10 normal cerebral vessel samples from cortical artery removed from traumatic temporal lobe were served as controls. All vessel samples were examined using immu- nohistoehemistry technique to detect the positive site and intensity of NF-КB and VEGF. Histopathology was performed to examine the arteriosclerosis of the vascular wall. Results Only weak immunoreactivities were detected in normal controls whereas strong es of NF-КB and VEGF were observed in 23 and 21 cases of aneurysms, respectively. The differences of NF-КB and VEGF immunoreactivities between aneurysms and controls were statistically significant （ P 〈 0. 01 ）. Both NF-КB and VEGF were mainly expressed in the endothelium and media layers of the aneurysms. Furthermore, the expression of NF-КB and VEGF were positively correlated with aneurysms （r3 = 0.740）. Different degrees of arteriosclerosis were observed in all vascular walls of aneurysms. Conclusions Both NF-KB and VEGF were highly expressed in the endothelium and media layers of the aneurysms which indicates a positive correlation with human aneurysms. Arteriosclerosis is an important pathology changes in aneurysms. The increase of NF-КB and VEGF might be one of key factors in the formation of arteriosclerosis and aneurysms.