破骨细胞分化因子及其相关因子在中耳胆脂瘤组织的表达

Expression of RANK-RANKl-OPG system in middle ear cholesteatoma

目的探讨破骨细胞分化因子(nuclear factor-kappa B ligand,RANKL)和其配体核因子-κB受体活化因子(receptor activator of nuclear factor-kappa B,RANK)及假性受体骨保护素(osteoprotegerin,OPG)即RANK-RANKL-OPG系统在中耳胆脂瘤的作用,儿童中耳胆脂瘤较成人骨质破坏严重的原因。方法应用免疫组织化学SP法观察RANKL和OPG在21例成人中耳胆脂瘤组织、17例儿童中耳胆脂瘤组织和18例正常外耳道深部皮肤中的表达,对染色结果进行量化处理和统计学分析。结果RANKL和RANKL/OPG比值在胆脂瘤的表达量明显高于外耳道皮肤,儿童胆脂瘤高于成人,差异有统计学意义(P<0.05)。结论①RANKL和RANKL/OPG比值的增高与胆脂瘤的骨质破坏有关,在中耳胆脂瘤骨质破坏的机制中起重要作用;②儿童中耳胆脂瘤RANKL/OPG比值较高,这可能是导致儿童中耳胆脂瘤比成人发展快,骨质破坏严重的一个重要原因。

OBJECTIVE To investigate the effect of nuclear factor-kappa B ligand-receptor activator of nuclear factor-kappa B-osteoprotegerin（RANKRANKL-OPG）system on bone resorption in middle ear cholesteatoma,and the reasons why middle ear cholesteatoma in children were more aggressive. METHODS The expression of RANKL and OPG in 21 adults cholesteatoma,17 children cholesteatoma and 18 normal external meatal skin was studied with immunohistochemistry. Semiquantitative analysis was used for comparison and statistical analysis. RESULTS RANKL-positive cells and the ratio of RANKL/OPG in cholesteatoma were significantly higher than that in external meatal skin （P〈0.05） . RANKL-positive cells and the ratio of RANKL/OPG in cholesteatoma of children were higher than that in adults （P〈0.05） . CONCLUSION The overexpression of RANKL and the increased ratio of RANKL/OPG in cholesteatoma were associated with the bone resorption. The ratio of RANKL/OPG in cholesteatoma of children was higher. Therefore, it may be an important reason why cholesteatoma in child could cause more extensive bone resorption.