粒细胞-巨噬细胞集落刺激因子在初发和复发性鼻息肉中的表达

Expression of GM-CSF in primary and recurrent nasal polyps

目的研究粒细胞-巨噬细胞集落刺激因子(granulocyte-macrophage colony-stimulation factor,GM-CSF)在初发鼻息肉和复发鼻息肉组织中的表达,探讨其在初发鼻息肉和复发鼻息肉发病机制中的作用。方法选择初发鼻息肉组40例、复发鼻息肉组40例,正常下鼻甲黏膜对照组20例,下鼻甲黏膜组织标本来自鼻中隔偏曲伴下鼻甲肥大的患者。采用免疫组织化学方法观察GM-CSF在初发鼻息肉组和复发鼻息肉组和正常下鼻甲黏膜中的表达,比较GM-CSF在初发性和复发性鼻息肉2组间和两组组内不同性别中表达的差异性。结果 GM-CSF阳性细胞主要表达在黏膜下层及血管周围,在初发性鼻息肉和复发性鼻息肉组间比较差异有统计学意义(P<0.05),2组内不同性别间比较差异无统计学意义(P>0.05)。在正常下鼻甲黏膜中无明显表达。结论 GM-CSF能够延长炎性细胞的存活时间,抑制炎性细胞的死亡,参加它们的趋化和浸润。致使大量GM-CSF向黏膜中聚集,促使局部炎症长期地存在,病变范围逐渐累及整个鼻腔以及多个和多组鼻窦,导致鼻息肉的形成和复发。

Objective To investigate the expression of granulocyte-macrophage colony-stimulation factor（ GM-CSF）in primary and recurrent nasal polyps. and to explore its effect in the pathogenesis of nasal polyps. Methods The patients were divided into three groups： primary nasal polyps group（ n = 40）,recurrent nasal polyps group（ n = 40）,control group（ normal inferior concha mucous membrane,n =20）,the tissue specimens of inferior concha mucous membrane were from the patients with deflection of nasal septum complicated by hypertrophic inferior turbinate. The expression levels of GM-CSF were detected by immunohistochemistry in three groups,and the differences of expression were compared between two groups and between females and males in one group. Results The positive cells of GM-CSF expression were mainly located in mucous membrane underlayer and the area around blood vessel,there were significant differences between primary nasal polyps and recurrent nasal polyps（ P〈 0. 05）,however,there were no significant differences between females and males in primary nasal polyps group or in recurrent nasal polyps group（ P〉 0. 05）. No obvious expression of GM-CSF was found in normal inferior concha mucous membrane tissues. Conclusion GM-CSF can lengthen the survival time of inflammatory cells,inhibit their death and participate in their chemotaxis and infiltration,which results in the aggregation of a lot of GM-CSF at the area of mucous membrane to promote long-term existence of local inflammation,as a result,the extent of disease involves gradually whole nasal cavity and many pieces or groups of nasal sinuses to result in the formation and relapse of nasal polyps.