直肠黏膜内脱垂组织中胶原纤维变化和CD68、BFGF、VEGF的表达及意义

Expression and significance of collagen fibers,CD68,BFGF and VEGF in internal rectal prolapse tissues

目的观察直肠黏膜内脱垂(IRP)组织中胶原纤维变化和CD68、碱性成纤维细胞生长因子(BFGF)、血管内皮生长因子(VEGF)的表达,为探索IRP的发病机制和临床治疗提供新思路。方法选取2020年6月至2021年9月于福建中医药大学附属第二人民医院因IRP行选择性痔上黏膜切除术(TST)的患者50例为IRP组,同期Ⅱ~Ⅲ期内痔(无合并IRP)行TST术患者50例为对照组。对术中截取的直肠组织进行Masson染色和免疫组化染色,观察胶原纤维的病理改变及CD68、BFGF、VEGF的表达情况。结果Masson染色显示,IRP组黏膜肌层及黏膜下组织胶原纤维比对照组显著减少(P<0.05),且胶原纤维的排列紊乱,伴间质疏松,血管扩张,数量增多。免疫组化染色显示,IRP组BFGF、VEGF、CD68的表达水平均明显高于对照组(P<0.05)。结论直肠黏膜内脱垂组织中胶原纤维减少,CD68、BFGF、VEGF的表达水平均升高,可能参与IRP的发生发展过程。

Objective To observe the changes of collagen fibers and the expression of CD68,basic fibroblast growth factor(BFGF)and vascular endothelial growth factor(VEGF)in internal rectal prolapse(IRP)tissues,and provide new ideas for the studies on pathogenesis and clinical treatment of IRP.Methods Fifty patients who underwent selective upper hemorrhoid mucosal resection(TST)for IRP in the Second People’s Hospital Affiliated to Fujian University of Chinese Medicine from June 2020 to September 2021 were selected as IRP group,and 50 patients who underwent TST for internal hemorrhoids(without IRP)at stageⅡ-Ⅲduring the same period were selected as control group.Masson staining and immunohistochemical staining were performed in the rectal tissue to observe the pathological changes of collagen fibers and the expression levels of CD68,BFGF and VEGF.Results Masson staining showed that the number of collagen fibers in mucosal muscle layer and submucosal tissue in IRP group was significantly lower than that in control group(P<0.05),and the arrangement of collagen fibers was disordered,accompanied by interstitial porosity and vasodilation.Immunohistochemical staining showed that the expression levels of BFGF,VEGF and CD68 in IRP group were significantly higher than those in control group(P<0.05).Conclusion Collagen fibers in rectal mucosal prolapse are decreased,and the expression levels of CD68,BFGF and VEGF are increased,which may be involved in the occurrence and development of IRP.