TNF-α和PGP9.5在椎间盘源性腰痛患者椎间盘MRI高信号区中的表达  

The express of tumor nerosis factor-α and protein gene product 9.5 in the lumbar disc displayed the high intensity zone on MRI

作　　者：任东风[1] 侯树勋[1] 吴文闻[1] 商卫林[1] 

机构地区：[1]解放军总医院第一附属医院骨科全军骨科研究所,北京市100037

出　　处：《中国脊柱脊髓杂志》2009年第10期725-728,共4页Chinese Journal of Spine and Spinal Cord

摘　　要：目的：探讨肿瘤坏死因子-α（TNF-α）和蛋白基因产物9．5（PGP9．5）与腰椎间盘MRI高信号的关系。方法：26例经椎间盘造影诊断的椎间盘源性腰痛患者，男16例，女10例，年龄26～65岁，疼痛源性椎间盘MRIT2像均可见高信号区（HIz区），均行手术治疗，取手术切除的椎间盘组织行TNF—α和PGP9．5免疫组化染色观察，并与4例脊柱侧凸患者矫形手术时取出的椎间盘组织进行对比。结果：椎间盘源腰痛患者椎间盘HIZ区对应部位的椎间盘组织表现为血管化肉芽组织和不同退变程度的髓核，可见大量增生的软骨样细胞和血管内皮细胞．免疫组化染色均可观察到TNF-α免疫染色阳性细胞和PGP9．5免疫阳性细胞；对照组没有观察到TNF-α免疫染色阳性细胞和PGP9．5免疫染色阳性细胞。HIZ区TNF—α免疫阳性细胞明显多于HIZ区周边纤维环组织和对照组（P〈0．05）．PGP9．5免疫阳性细胞亦明显多于HIZ区周边纤维环组织和对照组（P〈0．05）。结论：椎间盘源性腰痛患者腰椎间盘MRI的HIZ区中有大量TNF—α免疫阳性细胞和PGP9．5免疫阳性细胞表达，其可能是HIZ作为致痛源性椎间盘特异性影像标志物的基础。Objective：To observe the association of tumor nerosis factor-α（TNF-α） and protein gene product 9.5（PGP9.5） with the high intensity zone（HIZ） of the lumbar disc on MRI.Method：26 cases with discogenic back pain diagnosed by discography showed high intensity zone （HIZ） on T2 MRI in lumbar intervertehral disc,there were 16 males and 10 females,aged from 26-65 years.All cases underwent surgical treatment and discs were harvested during surgery.Disc samples were immunostained using antibodies to TNF-α and PGP9.5,which were compared with controls requiring surgery for scoliosis （n=4）.Result：The histologic study of the consecutive sagittal slices of the HIZ showed vascularized granulation tissue and degenerated nucleus pulposus,a lot of proliferated small round cells and fibroblasts presented,blood proliferation and inflammatory ceils infiltration were also seen.TNF-α and PGP9.5 immunostain positive cells were found in the experimental group and not found in the control group.The number of TNF-α and PGP9.5 immunostain positive cells were significantly higher in HIZ than that in the annulus fibrosus around HIZ and that of the control group （P〈 0.05）.Conclusion：High TNF-α and PGP9.5 expression in HIZ on MRI in the anulus fibrosus of patients with low back pain may indicate the inflammation mechanism for HIZ as specificity sign of painful disc on MRI.

关 键 词：椎间盘源性腰痛 高信号区 磁共振成像 肿瘤坏死因子-α 蛋白基因产物9.5 免疫组化 

分 类 号：R681.5[医药卫生—骨科学] R445.2[医药卫生—外科学]