PD-ECGF与VEGF在婴幼儿毛细血管瘤增生及退化机制中的作用

The role of PD-ECGF and VEGF in proliferative and involuted mechanism of the infantile capillaryhemangiomas

目的探讨血小板衍化内皮细胞生长因子（PD-ECGF）、血管内皮生长因子（VEGF）与毛细血管瘤增生退化关系，为其治疗提供理论依据。方法随机选取毛细血管瘤患儿40例为实验组，并据Mulliken标准分为增生期组（22例）及消退期组（18例），所有标本术后病理证实为毛细血管瘤；另选同期包皮手术患儿8例为正常皮肤对照组。将标本固定、包埋，HE染色，免疫组化法检测血管瘤增生期、消退期及正常皮肤内皮细胞中PD-ECGF及VEGF表达，并检测血管内皮标志抗原CD34表达，计算各期血管瘤及正常皮肤微血管密度（MVD）。应用SPSS12．0forwindows统计软件分析处理。结果增生期血管瘤、消退期血管瘤、正常皮肤PD—ECGF阳性率分别为95．45％（21／22）、77．78％（14／18）、37．50％（3／8）；VEGF阳性率分别为86．36％（19／22）、66．67％（12／18）、37．50％（3／8）；MVD为93．68±20．56、51．94±20．73、17．50±5．30。血管瘤不同分期之间，血管瘤与正常皮肤之间PD—ECGF、MVD差异均有统计学意义（P〈0．05）；血管瘤不同分期之间、增生期与正常皮肤之间，VEGF差异有统计学意义（P〈0．05），消退期与正常皮肤之间VEGF差异无统计学意义（P〉0．05）；PD-ECGD、VEGF与MVD的表达均呈正相关。结论PD-ECGF和VEGF在血管瘤增生期表达均高于消退期，两者相互协同作用，其表达水平与血管瘤增生退化密切相关；PD-ECGF可能通过表达胸苷磷酸化酶（TP）活性影响瘤体中微血管生成而发挥作用。

Objective To explore the relation between the expressions of PD-ECGF and VEGF and the evolution of capillary hemangioma, so as to provide theoretical basis for treatment. Methods Fourty cases with capillary hemangioma, proved by pathologic method, were randomly selected and divided into proliferative （n = 22） and involuted groups （n = 18） , according to the Mulliken standard. 8 specimens from 8 children with prepuce operation were used as control group. All the specimens were fixed, embedded and underwent HE staining. The expression of PD-ECGF, VEGF and CD34 in endothelial cells were detected by immunohistochemistry. The microvessel-density （MVD） was also calculated. The results were analyzed by SPSS12. 0. Results The positive expression rates of PD-ECGF and VEGF were 95.45% （21/22） and 86.36% （19/22） in proliferative hemangioma, 77.78% （14/18） and 66. 67% （ 12/ 18） in involuted hemangioma, 37.50% （3/8） and 37.50% （3/8） in normal skin. MVD in proliferative and involuted hemangioma and normal skin was 93.68 ± 20. 56, 51.94 ± 20. 73 and 17.50 ± 5.30, respectively. There was a significant difference in PD-ECGF expression and MVD between the proliferative and involuted groups, or between the hemangioma and control groups （ P 〈 0.05 ）. The VEGF was significantly different between the proliferative and involuted groups, or between the proliferative and control groups （ P 〈 0.05 ） , but not between the involuted and control groups （ P 〉 O. 05 ）. The expressionof VEGF, PD-ECGD and MVD showed a positive relationship. Conclusions PD-ECGF and VEGF have a synergetic effect in the proliferation of micro-vessels. PD-ECGF may enhance the activity of thymidine phosphorylase. They play an important role in the proliferation and involution of hemangioma.