肿瘤坏死因子-α在骨性关节炎滑膜中的表达及意义

Expression and significance of tumor necrosis factor-αin synovium in patients with osteoarthritis

目的探讨肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)在膝关节骨性关节炎(osteoarthritis,OA)发生、发展中的作用。方法53例OA患者手术切除膝关节滑膜标本为OA组,15例正常膝关节滑膜标本为对照组。应用Mankin评分系统进行滑膜组织形态学评分,采用免疫组织化学方法检测滑膜中TNF-α的表达,并进行2组间比较。结果 (1)对照组滑膜细胞分布均匀,分层良好,有少量空泡细胞;OA组滑膜细胞分布不均匀、稀疏,可见空泡细胞,有细胞簇集;(2)OA轻、中、重度退变组TNF-α积分吸光度值分别为0.058 7±0.019 6、0.201 7±0.056 2、0.417 5±0.083 2,均高于对照组(0.008 7±0.007 4)(P<0.05),且OA各组间TNF-α积分光密度值比较差异均有统计学意义(P<0.05);(3)TNF-α积分光密度值与Mankin评分呈正相关(r=0.901,P=0.000)。结论 TNF-α与OA发病和病情进展有一定相关性。

Objective To detect the role of tumor necrosis factor-α （TNF-α） in the development and progression of knee osteoarthritis （OA）. Methods Fifty-three knee synoviaI specimens from surgical resection in patients with knee OA （OA group） and 15 normal knee joint synovial specimens （control group） were evaluated the synovial tissue morphology score by Mankin scoring system, and detected the expression of TNF-α in synovium by immunohistochemistry method, which were compared between two groups. Results In control group, the synovial cells were distributed evenly, with fine layering and a small amount of vacuole cells. The distribution of synovial ceils in OA group was not uniform and sparse, and vesicular cells and cell clusters were seen in the cells. The optical density of TNF-α was 0. 058 7 ± 0. 019 6, 0. 201 7±0. 056 2 and 0. 417 5±0. 083 2 in mild, moderate and severe OA patients respectively, showing significant differences among groups （P〈0.05）, higher than that in control group （0.008 7±0. 007 4） respectively （P〈0.05）. The optical density of TNF-α score was positively correlated with Mankin score （r= 0. 901, P=0. 000）. Conclusion TNF-α is correlated with the development and progression of OA.