放疗性舌炎与其病损组织血管内皮细胞损伤的相关性研究

The Correlation between the Severity of Radiotherapy-induced Glossitis and the Injury of Endothelial Cells in the Local Tissues in A Rat Model

目的观察放射性舌炎病损局部病损组织血管内皮细胞损伤的动态变化,分析其与放射性舌炎病损程度的相关性。方法建立放射性舌炎SD大鼠动物模型;观察其放射性口腔黏膜炎指数(oral mucositis index,OMI);应用免疫组织化学方法(CD34)鉴定放射性舌炎病损局部病损组织血管内皮细胞;TUNEL检测RTG大鼠舌体病损组织内血管内皮细胞凋亡;统计学分析血管内皮细胞凋亡百分数与RTG口腔黏膜炎指数(OMI)间的时相变化关系。结果放射照射后3d可观察到明显的血管内皮细胞损伤和细胞凋亡,放射照射后的血管管腔变得明显不规则,管腔中可见有血栓形成,管腔内膜凹凸不平,血管扩张,管径变大,血管内皮细胞与基底膜分离脱落到管内,并可看到部分血管狭窄严重、闭塞。血管内皮细胞TUNEL检测到血管内皮细胞凋亡,5d组凋亡内皮细胞百分数(%)为(78.3±0.31),8d组为(89.3±0.83),14d组为(83.5±0.41),21d组为(69.3±0.57),28d组为(47.3±0.59)。5d、8d、14d、21d、28d时RTG口腔黏膜炎指数(OMI)与大鼠舌组织血管内皮细胞凋亡百分比的相关系数R=0.67(P=0.034)。结论RTG病损组织内血管内皮细胞损伤与RTG的病情相关,提示血管内皮细胞损伤可能在RTG病理过程中起作用并有潜在应用价值。

Objective To explore the correlation between the severity of radiotherapy-induced glossitis （RTG） and the injury of endothelial cells in the local tissues in a rat model. Methods RTG animal model was designed and employed by our team. OMI was documented daily. IHC （CD34） was utilized to identify the endothelial cells in the RTG tissues. The apoptosis of endothelial cells in RTG local lesion were detected by TUNEL assay. The dynamic relationship betweenOMI and apoptotie endothelial cells, were statistically analyzed by time course. Results After irradiation,the injury and apoptosis of endothelial cells were observed in 3 d. The vascular lumens of the post-irradiation tongue lesion became obviously irregular, the thrombosis formation in the center of the lumens, the wall of lumens was unsmooth, the vasodilatation vessels appeared, the endothelial cells detached from basal membrane and drop into the lumens. The percentages（%） of apoptotic endothelial cells were 78.3±0.31（5 d） ,89.3±0.83（8 d） ;83.5±0.41 （14 d）,69.3±0.57（21 d）, 47.3±0.59（28 d） respectively. The OMI were correlated with percentages of apoptotic endothelial cells（R=0.67 ,P=0.034）. Conclusion The injury of endothelial cells was correlated with the pathogenetic condition of RTG. The endothelial injury in the local lesion of RTG clinically necessitated further studied.