肩袖撕裂患者肩峰下滑囊中VEGF的表达

Expression of VEGF in subacromial bursa of patients with rotator cuff tear

目的 :观察细胞因子VEGF(血管内皮生长因子 )在肩袖撕裂患者肩峰下滑囊 (subacromialbursa ,SAB)中的表达 .方法 :在肩袖撕裂患者修复手术中 ,分别取撕裂处和远离撕裂处SAB ,对照组取非肩袖撕裂患者正常的SAB ,采用免疫组织化学方法观察VEGF在肩峰下滑囊中的表达 ,通过计算机图像分析系统对SAB切片的VEGF阳性表达进行定量分析 .结果 :实验组所有肩袖撕裂患者SAB中 ,无论是取自撕裂部位还是远隔部位 ,均可见细胞数量和血管分布的增加 ,且均未观察到有大量炎性细胞浸润 .实验组所有肩袖撕裂患者SAB中VEGF阳性表达均显著高于正常 ,且血管周围表达明显增高 ,经过统计学分析 ,肩袖撕裂患者SAB中VEGF较高表达与对照相比差异显著 ,然而撕裂部位与远隔部位相比无显著差异 .结论 :肩袖撕裂患者SAB中有炎性反应存在 ,本研究中VEGF在肩袖撕裂患者SAB中的增加与炎性反应密切相关 ,范围也不单纯局限于撕裂部位 .SAB的变化可能系组织炎性反应引起的继发反应 。

AIM: To investigate the expression of cytokine, vascular endothelial growth factor (VEGF) in the subacromial bursa (SAB) with rotator cuff tear. METHODS: For the experimental group, the subacromial bursa was obtained from patients with rotator cuff tear both at the tear site and distal to the tear site during surgery of rotator cuff repair. For the control group, the normal SAB was obtained from patients without rotator cuff tear. The specimens were processed for immunohistochemical analysis of VEGF. The number of the positive expression of VEGF was quantitated in the SAB using a computer image analysis system. RESULTS: The cells and blood vessels increased significantly in the SAB obtained from the both tear site and distal site in the patients with rotator cuff tear, compared with the normal bursa. However, no great infiltration of inflammatory cells was found. For the experimental group, the positive expression of VEGF was much higher than that of the control, and increased in the periphery of blood vessels. With statistics analysis, the expression of VEGF in the SAB of patients, who had had rotator cuff tearing, was significantly higher than that of control ( P <0.05), but no significant difference was fond between the tear site and distal site ( P >0.05). CONCLUSION: There is inflammation in the SAB of patients with rotator cuff tear. The increase of VEGF is closely related with inflammation and is found both at the tear site and distal site. The reaction of SAB might be secondary to the inflammation and be involved in the rotator cuff tear.