Notch1和血管内皮生长因子在出血性颅内动静脉畸形患者中的表达

Expression of Notch1 and vascular endothelial growth factor in hemorrhage from intracranial arteriovenous malformations

目的研究Notch1和血管内皮生长因子(VEGF)在出血性颅内动静脉畸形(AVM)中的作用。方法回顾分析温州医学院神经外科手术治疗的AVM患者,共35例,根据病史和影像学特点,将AVM患者分为出血性AVM组(简称出血组)27例、非出血性AVM组(简称非出血组)8例,应用免疫组化、荧光实时定量PCR分别检测两组畸形血管团内Notch1和VEGF的表达差异及相关性。结果①在出血组和非出血组中,Notch1和VEGF在畸形血管团内皮细胞均表达明显,但两组Notch1、VEGF表达阳性率比较,差异均无统计学意义。②出血组的Notch1 mRNA水平为1.9±1.7,高于非出血组的1.5±0.6;出血组的VEGF mRNA水平为4.2±3.0,高于非出血组的2.9+2.7,但两组比较差异均无统计学意义。③经Spearman相关分析,颅内AVM的Notch1与VEGF的阳性细胞率(r=0.638,P<0.05)及其mRNA水平(r==0.611,P<0.05)均呈正相关。结论 Notch1、VEGF在出血性AVM和非出血性AVM中均表达升高;但在出血性AVM中无特异性,Notch1与VEGF可能协同参与颅内AVM的形成。

Objective To investigate the roles of Notch1 and vascular endothelial growth factor（VEGF） in hemorrhage from intracranial arterovenous malformations（AVMs）.Methods A total of 35 patients with intracranial AVM treated in the Department of Neurosurgery,Wenzhou Medical College were analyzed retrospectively.The patients with AVM were divided into either a hemorrhagic AVM group（hemorrhagic group;n=27） or a non-hemorrhagic AVM group（non-hemorrhagic group;n=8） according to their medical history and imaging features.The malformation nidi in both groups were detected by immunohistochemistry and real-time fluorescence quantitative RT-PCR respectively.Results ①The mesothelial cells of Notch1 and VEGF expressed significantly within the malformation nidi in the hemorrhagic group and the non-hemorrhagic group.There was no significant difference in the positive rate of Notch1 and VEGF between the 2 groups.②The Notch1 mRNA level in the hemorrhagic group was 1.9±1.7,and it was higher than 1.5±0.6 in non-hemorrhagic group.The VEGF mRNA level in the hemorrhagic group was 4.2±3.0,and it was higher than 2.9＋2.7 in the non-hemorrhagic group.However,there was no statistically significant difference between the 2 groups.③Spearman correlation analysis showed that Notch1 of the intracranial AVMs had correlations with the positive cells rate of VEGF（r=0.638,P0.05） and the mRNA level（r=0.611,P0.05）.Conclusion Notch1 and VEGF expressed both in hemorrhagic and non-hemorrhagic AVMs,however it has no specificity in the hemorrhagic AVMs.Notch1 and VEGF may be synergistically involved in the formation of intracranial AVM.