翼状胬肉组织中血管拟态的初步研究  

Preliminary study of vascular mimicry in pterygium

作　　者：李永平[1] 朱哲[1] 张文忻[1] 

机构地区：[1]中山大学中山眼科中心中山大学眼科学国家重点实验室,广州510060

出　　处：《中华眼科杂志》2007年第10期872-875,共4页Chinese Journal of Ophthalmology

基　　金：国家自然科学基金资助项目（30672276）;广东省社会发展攻关资助项目（2003A3020302）;广州市科委领域专项资助项目（2004B30901011）

摘　　要：目的探讨血管拟态在翼状胬肉发病过程中的发生机制及其作用。方法对218例手术切除的翼状胬肉标本在光镜下进行形态学观察，其中97例行免疫组织化学、免疫组织化学（一抗为CD34、层粘连蛋白、血管内皮生长因子）联合过碘酸-希夫（PAS）组织化学双标染色，即一抗37℃孵育60min，二抗37℃孵育30min，辣根过氧化酶显色剂显色，0．5％高碘酸氧化10min，Schiffs液避光染色20min，Mayer苏木素复染3min，流水浸洗，中性树胶封片。结果218例翼状胬肉组织中97例出现了血管拟态的变化，表现为管状型和网状基质型。PAS染色血管拟态区网眼间隔染成紫红色。CD34免疫组织化学联合PAS组织化学双标染色显示构成网眼区内的支架突起与细胞为CD34阳性，外包绕有PAS染成紫红色的细胞外基质样物。层粘连蛋白免疫组织化学联合PAS组织化学双标染色显示血管内皮细胞与血管壁表达层粘连蛋白，但管样区内的细胞无明显阳性反应。血管内皮生长因子免疫组织化学联合PAS组织化学双标染色显示网状区内的纤维母细胞样细胞呈阳性反应，网眼间隔与细胞外基质物PAS染成紫红色。结论血管拟态结构存在于翼状胬肉组织中，血管拟态是其血供途径之一。Objective To investigate the role of vascular mimicry in the development of the pterygium. Methods Two hundred and eighteen pterygium specimens were collected from pterygium operations, 97 of them were studied under the light microscope by immunohistochemistry and immunohistochemistry combined with PAS stain （ primary antibodies included CD34, laminin and VEGF）. Specimens were incubated with primary antibodies at 37℃ for 60 mins, followed by incubation with secondary antibodies at 37℃ for 30 mins, stained by DAB, oxidized by 0. 5% periodic acid for 10 mins, stained by Schiffs staining for 20 mins, counterstained by Mayer-Hematoxylin staining for 3 mins, washed with water and then mounted. Results Vascular mimicry was identified in 97 of 218 pterygium specimens, which appeared as tubular type and network matrix type. The septas of meshwork stained positively with PAS stain. CD34 immunohistochemical staining combined with PAS staining showed that the arcs and cells in the meshwork were stained positively with CD34 and were encircled by PAS positive extracellular matrix. Laminin immunohistochemical staining combined with PAS staining showed that part of endothelial cells and blood vessel walls were stained positively by laminin, but most cells in the tubular-like region were stained negatively. VEGF immunohistochemical staining combined with PAS staining showed that fibroblast-like cells in the network matrix were stained positively by VEGF and the septas of meshwork and extracellular matrices were stained positively by PAS. Conclusion Vascular mimicry exists in the pterygium and is one of the blood supply pathways of the pterygium.

关 键 词：翼状胬肉 新生血管化 病理性 显微镜检查 免疫组织化学 

分 类 号：R686[医药卫生—骨科学]