色素上皮衍生因子在不同时期婴幼儿血管瘤组织中的表达

Expression of pigment epithelium-derived factor in different phases of infantile hemangiomas

目的研究不同时期婴幼儿血管瘤病灶内色素上皮衍生因子(pigment epithelium-derived factor,PEDF)表达水平的差异以及与婴幼儿血管瘤增殖、消退的关系。方法选择2010年5月至2012年6月来我科就诊,选择手术切除的血管瘤新鲜标本63例作为研究对象,根据Mulliken标准将其分为增生期(32例)及消退期(31例)。采用免疫组化、实时荧光定量RT-PCR,检测病灶组织内PEDF、血管内皮生长因子(vascular endothelial growth factor,VEGF)表达水平的变化,并通过CD34、Ki-67免疫组化染色,计算病灶内微血管密度(microvessel density,MVD)和Ki-67阳性率,分析与PEDF、VEGF表达水平的相关性。结果免疫组化与实时荧光定量RT-PCR结果均提示,增生期血管瘤病灶内PEDF表达水平明显低于消退期(P<0.05),而VEGF表达水平则明显高于消退期(P<0.05),且增生期、消退期血管瘤病灶PEDF/VEGF比值也存在统计学差异(P<0.05)。PEDF表达水平与MVD、Ki-67呈负相关,而VEGF表达水平则与MVD、Ki-67呈正相关。结论 PEDF与VEGF在婴幼儿血管瘤增殖、消退过程中起调节作用,PEDF可能与婴幼儿血管瘤自发消退密切相关。

Objective To investigate the expression differences of pigment epithelium-derived factor （PEDF） in the proliferating and regressing phases of infantile hemangiomas and their correlation with the proliferation and regression. Methods A total of 63 children with infantile hemangiomas admitted in our department from May 2010 to June 2012 were enrolled in this study. They all received selective surgery, and the obtained fresh specimens were divided into proliferating phage group （n = 32） and regressing phage group （n = 32） according to Mulliken. The expression of PEDF, vascular endothelial growth factor （VEGF）, Ki-67 and CD34 in the specimens at mRNA and protein levels was examined with quantitative real-time RT-PCR and immunohistochemical assay. Microvessel density （MVD） and rate of Ki-67 positive cells were analyzed with the expression of PEDF and VEGF. Results The protein and mRNA expression of PEDF were significantly lower in proliferative phase than in regressing phase （P 〈 0.05 ）, while the protein and mRNA expressions of VEGF were much higher （P 〈 O. 05 ）. The expression ratio of PEDF/VEGF had significant difference between the 2 phases （ P 〈 0. 05 ）. Significant positive correlation was found between the changes of MVD and Ki-67 and the expression of VEGF, while, negative correlation was seen between the changes and the expression of PEDF. Conclusion PEDF and VEGF play regulating roles in the proliferation and regression of infantile hemangiomas. PEDF might be correlated with the spontaneous regression of infantile hemangiomas.