血管内皮生长因子和碱性成纤维细胞生长因子在腰椎间盘突出组织中的表达及意义

Expression and significance of vascular endothelial growth factor and basic fibroblast growth factor in lumbar disc herniation tissues

目的 探讨血管内皮生长因子(VEGF)、碱性成纤维细胞生长因子(bFGF)在腰椎间盘突出(LDH)组织中的表达及临床意义。方法 选取LDH手术取得的48例椎间盘组织作为观察组,另选8例正常椎间盘组织作为对照;HE染色后观察椎间盘组织学变化,采用免疫组织化学检测椎间盘组织中VEGF、bFGF表达,分析VEGF、bFGF在正常椎间盘组织及不同病程、不同病理类型LDH椎间盘中的表达差异;采用Spearman秩相关分析LDH椎间盘组织中bFGF和VEGF表达的相关性。结果 对照组椎间盘组织未见新生血管及VEGF、bFGF阳性表达,观察组椎间盘组织中17例见新生血管、VEGF阳性33例(68.75%)、bFGF阳性41例(85.42%);破裂型LDH的VEGF阳性总表达率(87.5%)高于非破裂型(50%,P<0.05),病程> 12个月破裂型LDH的VEGF阳性表达率(75%)降低,但仍高于非破裂型(12.5%,P<0.05);bFGF阳性表达性率在7~12个月时开始降低,破裂型和非破裂型患者的bFGF阳性表达率比较,差异无统计学意义(P> 0.05);相关性分析结果显示,观察组患者椎间盘组织的bFGF和VEGF表达呈显著正相关关系(r_(s)=0.358,P=0.012)。结论 VEGF、bFGF在LDH组织中均有高表达,VEGF在破裂型LDH患者腰椎间盘组织中表达最高,且bFGF能促进VEGF的表达。

Objective To investigate the expression and clinical significance of vascular endothelial growth factor( VEGF) and basic fibroblast growth factor( bFGF) in lumbar disc herniation( LDH)tissues.Methods Lumbar disc herniation tissues of 48 patients with LDH were collected.8 cases of normal disc tissue were selected as controls.HE staining was used to determine the histopathological changes of the intervertebral disc.Then, immunohistochemistry was adopted to detect the expression differences of VEGF and bFGF in normal intervertebral discs and intervertebral discs of LDH patients with different courses or pathological types.Results No new blood vessels and positive expressions of VEGF and bFGF were found in the control group.In the observation group, new blood vessels were seen in 17 cases, 33 cases(68.75%) were positive for VEGF and 41 cases(85.42%) were positive for bFGF.The positive total expression rate of VEGF in ruptured type(87.5%) was higher than that of non-ruptured type(50%,P< 0.05).The positive expression rate of VEGF(75%) in ruptured patients with a course of disease more than 12 months decreased, but was still higher than that of nonruptured patients(12.5%,P< 0.05).The rate of bFGF positivity began to decrease at 7 to 12months.There was no significant differences in the positive expression rate of bFGF between ruptured and non-ruptured patients(P> 0.05).Correlation analysis showed that the expression of bFGF and VEGF was significantly positively correlated in tissues of observation group(r_(s)=0.358,P=0.012).Conclusion Both VEGF and bFGF are involved in the spontaneous absorption process of lumbar disc herniation, and bFGF can promote the expression of VEGF, and VEGF shows the highest expression in tissue of ruptured patients with LDH.