支气管扩张症肺组织内降钙素表达的临床意义

Clinical significance of calcitonin expression in lung tissue of patients with bronchiectasis

目的 了解支气管扩张症肺组织降钙素 (CT)蛋白表达水平与其病变特点的关系。方法 应用免疫组化方法定量分析 4 5例支气管扩张症患者手术切除的肺组织 ,对其气道上皮内神经内分泌细胞 (NEC)计数 ,并与 19例无肺部疾患的尸检肺组织进行比较。结果 2组均可见被染成棕红色的CT阳性细胞 ,它们分布于肺内各级支气管上皮细胞间 ,以支气管分叉处较多见。支气管扩张症组肺组织内5 0 0 0个上皮细胞中CT阳性细胞数为 (6 7.4 8± 11.0 3)个 ,非支气管扩张症组肺组织内CT阳性细胞数仅为 (5 .0 2± 1.0 0 )个 ,2组比较有非常显著性差异 (P <0 .0 0 1)。结论 支气管扩张症肺组织高水平CT表达可能与其慢性炎症改变有关 ,其局部CT表达增高可能系机体对支气管扩张病变的一种局部性代偿或调节机制。

Objective To investigate the relationship between pathlologic characteristics of bronchiectasis and expression of calcitonin (CT) protein in pulmonary neuroendocrine cell (NEC) of bronchiectasis.Methods CT expression in NEC was detected by immunohistochemistry and quantitative analysis was performed by counting CT positive cell numbers among 5 000 epithelial cells on a pathological section.The results were compared between the lung tissue by pneumonectomy in patients with bronchiectasis (n=45,experimental group) and normal lung tissue by autopsy(n=10,control group).Results CT-positive cells that were stained into brown red color could be found in both groups,which were distributed among different grades of bronchial epithelial cells in lung,especially in the bifurcation region of bronchus.In experimental group the numbers of CT-positive NEC were 67.48±11.03,and which were 5.02±1.00 in control group.There was a significant difference between two groups(P<0.001).Conclusion The high levels of CT expression in bronchiectasis are closely related to the change of chronic inflammation in bronchiectasis,which may be a kind of local compensatory or regulative mechanism for bronchiectasis.