利用Masson染色联合Ⅱ型胶原蛋白免疫组化染色对严重骨关节炎骨赘的组织学研究

A histologic study on osteophytes in severe osteoarthritis by Masson staining and immunohistochemical staining for collagen type Ⅱ

目的:利用Masson染色联合Ⅱ型胶原蛋白免疫组化染色建立骨关节炎骨赘的病理分类系统。方法:选取2012年至2015年招募符合排除/纳入标准的研究对象,手术获得膝骨关节炎骨赘标本,对骨赘标本行常规HE染色,Masson染色,甲苯胺蓝染色以及Ⅱ型胶原蛋白免疫组化染色观察,进行病例分类,评估病理分型系统与上述WOMAC评分及Kellgren-Lawrence影像学分级的一致性。结果:共有31例研究对象,101例骨赘样本纳入研究。骨赘可分为A型4.9%,B型4.0%,C型26.7%,D型骨赘64.4%。骨赘组织学分型与WOMAC评分一致性较好(X^2=0.108,P=0.947),骨赘组织学分型与影像学分级一致性较好(X^2=3.205,P=0.201)。结论:建立了骨关节炎骨赘的病理分型系统,其中A、B型为早期骨赘表型,C、D型为中晚期骨赘表型,上述分类有助于骨关节炎的临床与基础研究。

Objective To establish a histological classification system for osteophytes by Masson staining and immunohistochemical staining for collagen type II. Methods Osteophytes were collected from knee joints in os- teoarthritis patients after joint replacement surgery. To develop an osteophyte classification, serial tissue sections were identified using histological （hematoxylin and eosin, Masson＇s trichrome, toluidine blue） and immunohisto- chemical staining （collagen type Ⅱ ）. Joint function was assessed by WOMAC score and radiological findings was measured by Kellgren-Lawrence grading. The consistency between the osteophyte classification and WOMAC/Kell- gren-Lawrence grading were evaluated. Results 31 patients and 101 osteophyte samples were included in this study. Based on the histological and immunohistochemical evaluation, osteophytes can be divided into type A （4.9%）, type B （4.0%）, type C （26.7%） and type D （64.4%）. This histological classification system had better consistency with joint function score （x^2 = 0.108, P = 0.947） and Kellgren-Lawrence grading （x^2 = 3.205, P = 0.201）. Conclusions This trial establishes a histological classification system for osteoarthritis osteophytes, types A and B indicating early osteophyte and types C and D indicating advanced osteophyte. The system is helpful in clini- cal and basic research on osteoarthritis.