中枢神经系统海绵状血管瘤免疫组织化学研究

Immunohistochemical study on central nervous system cavernous hemangiomas

目的 了解中枢神经系统海绵状血管瘤 (CM)的组织结构、血管生成、增殖活性特点。方法 采用ABC法 ,对随机选取的 70例CM标本和 2 0例正常脑组织血管标本进行免疫组织化学染色 ,观察CD34、a 平滑肌抗 (a SMA) ;血管内皮细胞生长因子 (VEGF)、Flt 1、转化生长因子a(TGFa)、Ki6 7的表达 ,并根据染色强度进行对比分析。结果 所有正常脑组织血管中CD34、a SMA呈明显阳性 ,有很好的连续性 ,VEGF、Flt 1、TGFa无明显表达。 70例CM中 ,CD34、a SMA呈阳性表达的分别为 4 7例和 5 0例 ,有明显的不连续性 ;VEGF、Flt 1呈阳性表达的分别为 6 8例和 4 4例 ,弥散分布 ;TGFa呈阳性表达的为 6 8例 ;2种组织中该 5项指标的染色强度差异均有统计学意义 (P <0 0 5 )。Ki6 7在 2种组织中均无明显表达。结论 CM生物学特性主要与其血管壁组织结构的不成熟有关 ,各种血管因子发挥了相当重要的促进作用 ,CM本身的增殖活性有待进一步研究。

Objective To explore the histological structure, angiogenesis, and proliferative activity of central nervous system cavernous hemangiomas. Methods 70 surgical samples of central nervous system cavernous hemangiomas and 20 normal brain vessel samples from patients of epilepsy and open craniocerebral trauma were stained immunohistochemically with CD34, a-SMA;VEGF, Flt-1;and TGFa, Ki67 respectively. A comparison analysis was made according to the expression intensity. Results CD34 and a-SMA were expressed in all the normal control brain vessel tissues in a manner of obvious and continuous staining. VEGF, Flt-1 and TGFa were not expressed obviously in the normal brain tissues. 47 and 50 out of the 70 cavernous hemangioma specimens were positively stained for CD34 and a-SMA respectively,and their expression was less continuous. 68 and 44 out of the 70 cavernous hemangioma specimens were positively stained for VEGF and Flt-1 respectively with diffuse distribution. 68 cavernous hemangioma specimens were positively stained for TGF-a. A significant difference in expression intensity was found for the above 5 factors between the normal control brain tissue and cavernous hemangiomas (all P <0.05). No expression of Ki67 was detected in all samples. Conclusion The biological characteristics of cavernous hemangiomas are mainly relevant to the immaturity of the vessel wall. A series of angiogenic factors play an important role in the development of the lesion. The proliferative activity of the cavernous hemangiomas needs to be studied further.