转移生长因子-β_1和C-MYC癌基因在先心肺高压肺血管组织中的表达及意义  

Expression and significance of transforming growth factor β_1 and C-MYC gene in the pulmonary blood vessel of patients with congenital heart disease associated with pulmonary hypertension.

作　　者：付静[1] 董铭峰[1] 马增山[1] 马胜军[1] 刘桂清[1] 

机构地区：[1]聊城市人民医院,山东聊城252000

出　　处：《山东医药》2007年第29期18-20,共3页Shandong Medical Journal

基　　金：山东省科学技术厅星火计划资助项目(022130361)

摘　　要：目的研究左向右分流型先天性心脏病(CHD)合并肺动脉高压(PH)肺血管中转化生长因子-β1(TGF-β1)和原癌基因C-MYC的表达与PH病理的关系,探讨其在CHD并PH形成过程中的作用。方法将112例左向右分流CHD患者按肺动脉平均压(MPAP)高低分为正常组(MPAP<20 mmHg)33例,PH组(MPAP>20mmHg)55例,重度PH组(MPAP>70 mmHg)24例。三组均行肺活检术,免疫组化方法检测肺血管组织中TGF-β1、C-MYC癌基因的定位及表达情况。结果TGF-β1主要分布于肺动脉内皮细胞、肺动脉平滑肌和成纤维细胞等细胞的胞质中,且有片状分布。C-MYC癌基因主要分布于肺动脉内皮细胞、肺动脉平滑肌和成纤维细胞等细胞的胞核中。TGF-β1和C-MYC癌基因表达强度(A)随肺小动脉病理分级的加重而升高,在各组之间有明显差异(P<0.05),二者表达与病理分级有明显相关性(P<0.05)。结论TGF-β1和C-MYC癌基因在CH合并PH的形成过程中起重要生物学作用,TGF-β1对C-MYC癌基因起正性诱导作用,促进平滑肌细胞和成纤维细胞增殖。[ Objeetive]To study the expression of transforming growth factor β1 （TGF-β1） and C-MYC gene in the pulmonary blood vessel of patients with congenital heart disease（CHD） associated with pulmonary hypertension（PH） , and their relationship with pathological behavior of grading and staging of PH. To explore their roles in the genesis of CHD eom- plleated with PH. [ Methods] 112 patients with CHD were divided into three groups： no-PH group （33patients）, with preoperative mean pulmonary artery pressure （MPAP） 〈 20 mmHg; PH group （55patients） , with preoperative MPAP 〉 20 mmHg, and eyanosis group （24patients） , with preoperative MPAP 〉70 mmHg. The lung tissue samples were examined from 112 patients by surgical biopsy of lung . Lung tissue was examined for expression of TGF-β1 and C-MYC by immuno- histochemieal technique. Pathological grading of pulmonary vascular changes was standardized by Heath-Edwards. [ Resuits] TGF-β1 was found mairdy in the cytoplasm of endotheliocyte, smooth muscle cells and fibroblasts of pulmonary artery. C-MYC gene was found mainly in the karyon of endotheliocytes, smooth muscle ceils and fibroblasts of pulmonary artery. The intensity（A） of TGF-131 and C-MYC expression in the lung tissues of PH groups was increased gradually with the grading increasing. The intensity expression（A） of TGF-β1 and C-MYC in the lung tissues in all pathological degree groups showed statistic differences. The expression of TGF-β1 and C-MYC had significant correlation with pathological grade. [Conclusion] TGF-β1 and C-MYC gene have an important biological behavior in the genesis of PH of CHD. TGF-β1 induces C-MYC gene positively. They improve the proliferation of smooth muscle cell and fibroblasts.

关 键 词：TGF-Β1 C-MYC癌基因 肺动脉高压 先天性心脏病 

分 类 号：R541.1[医药卫生—心血管疾病]