膜性肾病患者肾组织肥大细胞的分布及病理意义

Distribution and pathological significance of renal mast cells in patients with membranous nephropathy

目的了解肥大细胞在各种病理类型膜性肾病患者肾组织中的分布及其病理意义。方法选取各个病理类型膜性。肾病病例共55例，正常供。肾8例；检测肾活检组织中肥大细胞，分析其与相关临床病理指标的相关性。结果肥大细胞主要分布于损伤的小管和小球周围的间质中。膜性肾病患者肾组织肥大细胞较对照组显著增加。I期患者肥大细胞较少，其他组间无显著差异。患者肾组织肥大细胞数量与反映肾组织损伤的指标，特别是小管和小管间质损伤指标具有显著相关性。结论上述结果提示肥大细胞参与了膜性肾病的小管间质慢性病变过程，作为膜性肾病的一种新致病因素，一个潜在的膜性肾病肾组织慢性病变防治新靶标，肥大细胞值得关注。

Objective To observe the distribution and number of mast cells in the renal tissues of patients with membranous nephropathy at different pathological stages and to investigate the pathological significance of mast cells. Methods Renal tissue samples from 55 membranous nephropathy patients of different pathological stages with available full clinical and pathological data and from8 normal kidney donors were collected in this study. The number and distribution of mast cells in each tissue section was observed by immunochemical staining for the cell specific marker C3aR. Then the mast cell density in the cortex was calculated. The correlation of mast cells with patients＇ clinical and pathological indices was analyzed. Results Mast ceils were mainly distributed in the tubular interstitial area, especially in the area with injured tubules and glomeruli. There were more renal mast cells in the patients with membranous nephropathy of all pathological types when compared with the normal controls. No significant difference in the number of renal mast cells was found between the groups of different pathological stages except stage I group having less ceils. The number of renal mast ceils was correlated with indices reflecting renal injury, especially with the indices reflecting renal tubular and interstitial injury. Conclusion Our results indicate that mast cells are involved in the pathogenesis of membranous nephropathy, especially in the chronic tubular interstitial injury. As a possible new pathogenic factor and a new therapeutic target, renal mast cells deserve attention in the treatment of membranous nephropathy.