HIF-1α和VEGF在慢性滑膜炎中的表达及其与毛细血管密度的关系

Expression of hypoxia-inducible factor-1α and vascular endothelial growth factor in chronic synovitis and its relationship with capillary density

目的检测滑膜HIF-1α、VEGF、CD34表达水平,观察慢性滑膜炎滑膜组织的组织病理学形态改变,了解HIF-1α、VEGF与毛细血管密度(MVD)及组织学分级之间的关系。方法应用免疫组织化学技术对获得的45例滑膜组织进行HIF-1α、VEGF、CD34染色,HE染色观察慢性滑膜炎滑膜组织病理学形态并进行病理评分及分级,分析相关关系。结果 HIF-1α、VEGF在慢性滑膜炎患者滑膜组织中高表达,表达率分别为68.9%、80%,明显高于正常对照组10%、20%(P<0.05),MVD在慢性滑膜炎组织中较正常对照组明显增高,HIF-1α与VEGF相关(r=0.525,P<0.01),HIF-1α与MVD相关(r=0.867,P<0.01);光镜下可见病变滑膜细胞明显增殖,并伴有大量增生血管,血管周围可见多量淋巴细胞、浆细胞浸润,HIF-1α与滑膜炎的病理学分级正相关(r=0.526,P<0.01)。结论慢性滑膜炎滑膜中HIF-1α、VEGF与MVD具有相关性,滑膜的增生及滑膜炎的持续可能与HIF-1α引起的血管增生有关,滑膜形态学观察有助于滑膜炎的分级及监测。

Objective To detect synovial HIF-1α,VEGF and CD34 expression levels,to observe the histopathological change in synovial tissue,and to explore the relationship among HIF-1α,VEGF,capillary density（MVD） and histological grading.Methods HIF-1α,VEGF,CD34 and HE staining were carried out in 45 samples of synovial tissue for assessment of pathological score and staging,and analysis of correlation was performed.Results Expression of HIF-1α and VEGF in patients with chronic synovitis was significantly higher than that in normal control group（68.9% vs 10% and 80% vs 20%,P〈0.05）.MVD was significantly higher in patients with chronic synovitis than that in normal control group.Spearman-related analysis revealed significant correlations between HIF-1α and VEGF（r=0.525,P〈0.01） and HIF-1α and MVD-related（r=0.867,P〈0.01）.Light microscopic imaging revealed prominent proliferation of synovial cells,vascular proliferation and perivascular infiltration of lymphocytes and plasma cells.Moreover,significant positive correlation was proved between HIF-1α and pathological grading of synovitis（r=0.526,P〈0.01）.Conclusion In patients with chronic synovitis,HIF-1α and VEGF are correlated with MVD.Furthermore,synovial hyperplasia may be resulted from HIF-1α-induced vascular proliferation.Synovial morphologic observation would benefit staging and monitor of synovitis.