SOX9、L-SOX5、SOX6及Ⅱ型胶原在青少年特发性脊柱侧凸患者顶椎终板软骨的共表达及意义

The coexpression of SOX9,L-SOX5,SOX6 and Type Ⅱ collagen in endplate cartilage of apex vertebra in adolescent idiopathic scoliosis and its significance

目的:观测SOX9、L-SOX5、SOX6及Ⅱ型胶原在青少年特发性脊柱侧凸(adolescent idiopathic scoliosis,AIS)患者顶椎终板软骨中的表达,探讨其与AIS发生、发展的关系。方法:12例AIS患者,每例在前路手术时截取顶椎终板软骨1份,每份标本均包含凸侧与凹侧。切片行HE染色观察其组织细胞形态;行免疫组织化学染色,应用病理图像分析系统观测凸侧与凹侧的SOX9、L-SOX5、SOX6及Ⅱ型胶原表达的阳性细胞数和累积光密度(IOD),并计算这4个因子表达的相关性。结果:HE染色显示终板软骨有类似四肢长骨骺板样软骨内成骨组织形态,与凹侧比较凸侧显示了更强的软骨细胞活性。凸侧SOX9、L-SOX5、SOX6及Ⅱ型胶原表达的阳性细胞数和前三者的IOD值均明显大于凹侧,差异均有显著性(P<0.05),凸侧Ⅱ型胶原表达的IOD值与凹侧比较无显著性差异(P>0.05),4个因子表达的阳性细胞数之间的相关系数为0.46～0.91(P<0.05),IOD之间为0.64～0.98(P<0.05),均呈正性相关。结论:AIS患者顶椎凸侧与凹侧终板软骨的组织形态学及SOX9、L-SOX5、SOX6和Ⅱ型胶原的表达均存在差异,其可能是脊柱不同部位间机械应力差异下的继发性变化;4个因子的共表达异常触发AIS的可能性小。

Objective：To investigate the expression of SOX9,L-SOX5,SOX6 and type Ⅱ collagen in endplate cartilage of apex vertebra of patients with adolescent idiopathic scoliosis（AIS） and explore their possible correlation with the pathogenesis and development of AIS.Method：Twelve AIS patients were recruited in the study.Each portion of endplate cartilage including the convex and concave side was obtained respectively through anterior approach operation.The histomorphology was studied by hematoxylin and eosin（HE） stain.Expression differences for positive cell population and integrated optical density （IOD） on SOX9,L-SOX5 ,SOX6 and type Ⅱ collagen between the convex and concave side were evaluated by immunohistochemistry and pathological image analysis system.Then the correlative modules between the corresponding index of above four factors were calculated.Result：Histomorphology of entochondrostosis in endplate cartilage was similar to that in epiphyseal plate of long bone of limbs by the HE.Compared with the concave side,chondrocytes of the convex side demonstrated stronger activity.The positive cell population for all of the above four factors and IOD for soxg,L-SOX5 and SOX6 in the convex side were greater than those in concave side by immunohistomorphology,the differences were statistically significance（P〈0.05） except for IOD index on type Ⅱ collagen.lt was discovered that correlation coefficient for the positive cell population of corresponding index among the four factors was 0.46-0.91 and for IOD index was 0.64-0.98,so the correlative P-value were all less than five percentage （P〈0.05）.The correlation of the expression of the four factors was positive.Conclusion：Both histomorphology and the expression of the four factors in the endplate cartilage between convex and concave side of apex vertebrae of patients with AIS appear difference,that is likely secondary to the variance of mechanical stress onto different parts of the vertebral column.It is hardly possible that AIS can be triggered by abnormal coexpression of the four factors.