巨脾大部切除后残脾微血管密度和CD34、VEGF、VEGFR-2表达的临床研究  

Microvessel density and expression of CD34、VEGF、VEGFR-2 in residual spleen after subtotal splenectomy due to portal hypertension

作　　者：鞠玲燕[1] 王磊[2] 王涛[1] 王美红[1] 徐永波[3] 李坤[3] 唐金元[3] 褚海波[3] 

机构地区：[1]中国人民解放军第89医院病理科,山东潍坊261021 [2]潍坊医学院研究生部,山东潍坊261042 [3]中国人民解放军第89医院普外中心,山东潍坊261021

出　　处：《中国现代普通外科进展》2016年第2期95-99,共5页Chinese Journal of Current Advances in General Surgery

基　　金：潍坊市科技发展计划基金(2014zj1058);解放军第89医院科研资助基金(yz2013890201)

摘　　要：目的:观察巨脾大部切除后残脾VEGF、VEGFR-2、CD34的表达,探讨残脾微血管密度(MVD)变化。方法:选取门静脉高压脾肿大患者13例,术后切取脾组织为巨脾组,术后8年穿刺获取脾组织为残脾组,另设外伤性脾组织13例为对照组。应用免疫组织化学方法,并对残脾MVD进行定量分析。结果:残脾组红髓MVD为(12.54±1.32)个/高倍视野,脾实质为(16.64±1.10)个/高倍视野;巨脾组红髓MVD为(16.72±1.41)个/高倍视野,脾实质为(21.20±1.52)个/高倍视野;对照组红髓MVD为(9.65±1.47)个/高倍视野,脾实质为(13.56±1.14)个/高倍视野。巨脾组MVD值与残脾组、对照组比较明显增高,差异有统计学意义(P<0.01);残脾组MVD值与对照组比较明显增高,差异有统计学意义(P<0.01)。在脾脏组织CD34表达阳性,VEGF和VEGFR-2表达阴性。结论:巨脾大部切除后残脾MVD减少,VEGF和VEGFR-2阴性表达。Objective： To observe the expression ofVEGF, VEGFR- 2, CD34 in residualsplenic tissue after subtotal splenectomy due to portal hypertension, in order to investigate the changes of microvesseldensity（MVD）.Methods： 13 cases of splenomegaly due to portal hypertension which were removed surgically were examined as splenomegaly group. After eight years, another specimens as residual spleen group was obtained by puncture biopsy. Then 13 traumatic spleen as control group was seted. Immunohistochemistrywas used to observe MVDin residualspleen under light microscope. Results：The MVD of red pulp and spleen parenchyma in the residual spleen group, splenomegaly group and control group were（12.54 ±1.32）pieces/per high- power field and（16.64 ±1.10）pieces/per high- power field,（16.72±1.41）pieces/per high- power field and（21.20±1.52）pieces /per high- power field,（9.65±1.47）piece/per high- power field and（13.56±1.14）pieces/per high- power field, respectively.Asignificantly higher the MVD of red pulp and spleen parenchyma was observed in splenomegaly group compared with residual spleen group and the control group（P〈0.01）;A significantly higher the MVDof red pulp and spleen parenchyma was observed in residualspleen group compared with the control group（P〈0.01）.In splenic tissue, the positive expression of CD34 was observed, but the negative expression of VEGF and VEGFR- 2 were noted. Conclusion： After subtotal splenectomy, the MVD of residualspleen was reduced, and the negative expression ofVEGF and VEGFR- 2 were observed.

关 键 词：残脾 脾肿大 微血管密度 血管内皮生长因子 血管内皮生长因子受体 CD34 

分 类 号：R329.4[医药卫生—人体解剖和组织胚胎学] R322.21[医药卫生—基础医学]