颈椎成骨性退变间盘组织学改变及局部骨化灶的潜在形成机制  

Histological changes of cervical disc tissue and underlying ossification mechanism in patients with cervical degenerative ossification

作　　者：熊洋[1,2] 杨莹骊 高誉珊 王秀梅 杨永栋 赵丁岩[1] 赵赫 李传鸿[1] 杨凯坦 俞兴 Xiong Yang;Yang Yingli;Gao Yushan;Wang Xiumei;Yang Yongdong;Zhao Dingyan;Zhao He;Li Chuanhong;Yang Kaitan;Yu Xing(Department of Orthopedics,Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100700,China;School of Materials Science and Engineering,Tsinghua University,Beijing 100084,China;Department of Traditional Chinese Medicine,Peking Union Medical College Hospital,Beijing 100032,China;School of Chinese Medicine,Beijing University of Chinese Medicine,Beijing 100029,China)

机构地区：[1]北京中医药大学东直门医院骨科,北京市100700 [2]清华大学材料学院,北京市100084 [3]北京协和医院中医科,北京市100032 [4]北京中医药大学中医学院,北京市100029

出　　处：《中国组织工程研究》2022年第18期2868-2873,共6页Chinese Journal of Tissue Engineering Research

基　　金：仿生矿化胶原人工骨在脊柱疾病及骨折治疗中的疗效观察,项目负责人:俞兴。

摘　　要：背景:病变椎间盘周围成骨性退变可加重神经压迫,增加手术风险。但目前国内外对临床颈椎成骨性退变患者间盘组织学的改变及潜在成骨机制鲜有报道。目的:对颈椎成骨性退变患者病变椎间盘进行组织学观察,并初步探索局部骨化灶潜在形成机制。方法:临床筛选颈椎病手术治疗患者,术中收集手术节段病变椎间盘组织,根据术前颈椎X射线片及CT检测将所有椎间盘样本分为成骨组和非成骨组。对两组样本进行苏木精-伊红染色、Masson三色染色及番红O固绿软骨染色比较椎间盘组织学差异;通过免疫组织化学方法并进行半定量检测比较两组椎间盘及骨赘样本中转化生长因子β1及其下游p-Smad2/3的表达水平。结果与结论:①椎间盘样本可明确区分外层纤维环、内层纤维环及髓核,骨化样本中均可明确观察到成熟的骨小梁及骨髓腔;②组织学上,成骨组椎间盘内细胞数量显著多于非成骨组(P<0.05);但基质中蛋白多糖含量显著低于非成骨组(P<0.05);③转化生长因子β1/Smad2/3在所有椎间盘及骨赘组织中均可见;④成骨组转化生长因子β1、p-Smad2及p-Smad3在局部的含量均显著高于非成骨组(P<0.05);⑤结果显示,与非成骨性退变相比,颈椎成骨性退变患者的椎间盘组织退变更为严重;局部微环境中更高含量的转化生长因子β1对成骨性退变或具有促进作用,而下游活化的p-Smad2/3对成骨的作用存在差异。BACKGROUND:Cervical degenerative ossification may aggravate nerve compression in patients with cervical degenerative disease,and also make the decompression procedure more challenging.However,the accompanied histological changes of the intervertebral disc and the underlying mechanism of degenerative ossification have not yet been documented.OBJECTIVE:To explore the histological features of the cervical disc in patient with cervical degenerative ossification and the underlying mechanisms of local ossification.METHODS:Patients with cervical spondylosis undergoing surgical treatment were selected from the clinical practice,and cervical disc samples were harvested during the surgical process.Based on preoperative cervical X-ray and computed tomography(CT)examinations,all the disc samples were divided into ossification group and non-ossification group.Hematoxylin-eosin staining,Masson trichrome staining and Safranin O-fast green staining were used to compare the histological differences between the two groups.Furthermore,for the expression of transforming growth factor-β1,p-Smad2 and p-Smad3 in the disc and osteophyte samples,a semi-quantitative immunohistochemistry method was used to compare the difference between the two groups.RESULTS AND CONCLUSION:All the disc tissues could be clearly divided into the outer annulus fibrosus,the inner annulus fibrosus and the nucleus pulposus.Mature trabeculae and bone marrow cavities were detected in all ossification samples.Histologically,the number of disc cells in the ossification group was significantly higher than that of the non-ossification group(P<0.05).However,the content of proteoglycan in the matrix was significantly lower than that in the non-ossification group(P<0.05).Transforming growth factorβ1/Smad2/3 was detected in all the disc and osteophyte tissues.Local content of transforming growth factorβ1,p-Smad2 and p-Smad3 in the ossification group was significantly higher than that of the non-ossification group(P<0.05).All the findings indicate that,compared with th

关 键 词：颈椎病 颈椎间盘 椎间盘退变 成骨性退变 骨赘 组织学 转化生长因子β1 SMAD2/3 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学]