PCNA和FasL在鼻息肉术后囊泡上皮细胞中的表达

Expression of PCNA and FasL in the epithelia of vesicle tissues after endoscopic polypectomy

目的观察增殖细胞核抗原(PCNA)和凋亡相关因子配体(FasL)蛋白在鼻息肉术后囊泡上皮细胞中的表达,深入了解鼻息肉早期形成的病理特点,加深对鼻息肉发病机制的理解。方法鼻息肉术后2周,取患者术腔内囊泡组织25例,对照组为正常下鼻甲组织15例,石蜡包埋,HE染色确诊并观察组织结构。PCNA和FasL蛋白检测采用免疫组化染色法。结果①光镜下观察:术后增生组织形态学改变与鼻息肉相类似,22例囊泡上皮为假复层纤毛柱状上皮,3例为复层鳞状上皮,基底膜没有明显增厚,固有层水肿,上皮层及上皮下层有炎性细胞浸润;大部分病例上皮下可见黏液腺、混合腺及其导管,上皮下小血管扩张。②术后两周术腔囊泡组织上皮层PCNA、FasL阳性细胞的平均光密度均明显高于对照组(P均<0.05)。③增生组织上皮细胞PCNA与FasL阳性细胞的平均光密度值呈显著正相关(r=0.742,P=0.017)。结论鼻息肉术后囊泡上皮表现出较强的增殖活性,可能与鼻息肉术后复发有密切关系;FasL介导的免疫逃避机制可能是上皮细胞过度增殖的原因。

Objective To study the expression of PCNA and FasL in the epithelia of vesicle tissues after endoscopic polypectomy and to deeply investigate the pathologic characteristic and pathogenesis of nasal polyps in the early stages.Methods 25 patients with nasal polyps undergone endoscopic sinus surgery and 15 controls from inferior turbinate mucosa were observed.The vesicle tissues situated in the postoperative cavity two weeks later after operation were observed with light microscopy by formalin-fixed paraffin-embedded slides with hematoxylin-eosin staining.By immunohistochemical staining,we researched the protein expression of PCNA and FasL.Results ①Under light microscopy ： Morphological changes of the Vesicle tissues were similar with nasal polyps.The epithelia of vesicle tissues were pseudostratified ciliated columnar epithelium（22/25）,and some were stratified squamous epithelium（3/25）.Lamina propria were edema.Inflammation cells infiltrated epithelial lining and subepithelial lining.In most cases we also found formation of mucous gland in the sub-epithelial lining,and small vascular ectasia.②For the expression of PCNA and FasL between the two groups,their average density of light in epithelia were both statistically significant（all P〈0.05）.③ In the epithelia of vesicle tissues,it displayed positive correlation between the expression of PCNA and that of FasL（r=0.742,P=0.017）.Conclusions The epithelia of vesicle tissues show high proliferative activity,and it may play an important role in the recurrence of nasal polyps postoperatively.Immune escape mechanism by cell induced expression of FasL may be the reason for epithelia escaping immune surveillance to realize the epithelial proliferation and differentiation.