复发性翼状胬肉中MUC5AC与iNOS的表达及意义

Significance and expression of MUC5AC and iNOS in recurring pterygium

目的检测MUC5AC及诱导型一氧化氮合酶(inducible nitrc oxide synthase,iNOS)在复发性翼状胬肉组织中的表达水平,初步探讨MUC5AC和iNOS在翼状胬肉复发过程中的作用机制。方法 应用SP免疫组织化学染色法检测5例正常结膜组织、6例原发性翼状胬肉组织及22例复发性翼状胬肉组织中MUC5AC和iNOS的免疫学定位及表达,所有病例术前均检查泪膜破裂时间(breakup time,BUT)、SchirmerⅠ试验,并分析各影响因素之间的相关性。结果 正常结膜组、原发性翼状胬肉组及复发性翼状胬肉组的SchirmerⅠ试验结果分别为(10.86±0.80)mm、(9.97±0.34)mm、(9.32±0.51)mm,BUT分别为:(10.40±0.16)s、(9.65±0.26)s、(9.00±0.55)s,各组间比较差异均有统计学意义;复发性翼状胬肉组中MUC5AC的着色强度与正常结膜组比较差异有统计学意义(P<0.05),MUC5AC阳性细胞数与正常结膜组和原发性翼状胬肉组比较差异均有统计学意义(均为P<0.05);经半定量分析,3组间iNOS的表达,差异均有统计学意义;Spearman相关分析,MUC5AC的表达与BUT呈负相关(r=0.616,P<0.01),与iNOS呈正相关(r=0.385,P<0.05)。结论 翼状胬肉切除术后泪膜稳定性下降、杯状细胞形态功能发生改变、MUC5AC的高表达可能与翼状胬肉术后复发有关。

Objective To detect the expression of MUC5AC and inducible nitric oxide synthase （iNOS） in human recurring pterygium and to evaluate the mechanisms of them in recurring pteryginm. Methods The immunohistochemical SP method was used to examine the expression of MUC5AC and iNOS in 5 cases of normal conjunctiva, 5 cases of primary pterygium and 22 cases of recurring pterygium. BUT and Schimer I test were taken in all cases before operation. Correlations among factors were analyzed. Results Schirmer I test were （ 10. 85 ± 0.80 ） nun, （9.97 ± 0.34 ） mm and （9.32 ± 0. 51）mm,BUT were （10.40 ±0. 16）s, （9.55±0.25）s and （9.00±0.55）s in normal conjunctival group, primary pterygium group and recurring pteryginm group （ all P 〈 0. 05 ）. There were significant differences. There were significant differences in staining of MUC5AC between recurring pterygium and normal conjunctival group （ P 〈 0.05 ）, in number of MUC5AC positive ceils for recurring pterygium group compared with normal conjunctival group and primary pterygium group （ both P 〈 0.05 ）. Semi-quantitative analysis showed statistical difference in expression of iNOS among 3 groups. Spearman correlation analysis showed negative correlation of MUC5AC with BUT and positive correlation of MUC5AC with iNOS（ r = 0. 515 ,P 〈 0.01 ;r = 0. 385 ,P 〈 0.05 ）. Conelusions After excision of pterygium, tear-film stability decreases, the morphologies of goblet ceils change, and the high expression of MUC5AC may have relation with recurrence of pterygium after excision.