胆囊胆固醇性息肉和胆囊胆固醇性结石形成的影响因素及作用机制研究  

Study on the influencing factors and mechanism of cholesterol polyps and cholesterol calculus in gallbladder

作　　者：许臣 于志浩 郑亚民[1] 高巍[2] 刘爽[1] 王伟民 李征[1] 周震[3] 高翔[1] Xu Chen;Yu Zhihao;Zheng Yamin;Gao Wei;Liu Shuang;Wang Weimin;Li Zheng;Zhou Zhen;Gao Xiang(Department of General Surgery,Xuanwu Hospital,Capital Medical University,Beijing 100053,China;Department of Pathology,Xuanwu Hospital,Capital Medical University,Beijing 100053,China;School of Biomedical Engineering,Capital Medical University,Beijing 100053,China)

机构地区：[1]首都医科大学宣武医院普通外科,北京100053 [2]首都医科大学宣武医院病理科,北京100053 [3]首都医科大学生物医学工程学院,北京100053

出　　处：《中华肝胆外科杂志》2023年第6期438-443,共6页Chinese Journal of Hepatobiliary Surgery

摘　　要：目的通过研究胆囊黏膜上皮粘蛋白(MUC)表达与胆固醇逆转运(RCT)的差异,探索胆囊胆固醇性息肉(GCP)和胆囊胆固醇性结石(GCC)形成的影响因素及发病机制。方法回顾性分析2021年1月至12月在首都医科大学宣武医院普通外科行胆囊切除术的10例GCP和10例GCC患者的临床资料,依据术后病理结果分为GCP组和GCC组。另选取本院同期收治的切除了正常胆囊的5例患者(因外伤、肝硬化、肝移植等疾病导致胆囊切除)作为对照组。10例GCP组患者中,男性5例,女性5例,年龄(43.40±9.59)岁。10例GCC组患者中,男性5例,女性5例,患者年龄(45.00±8.13)岁。5例对照组中,男性3例,女性2例,年龄(43.80±6.01)岁。免疫组化分析MUC各个亚型及RCT蛋白[ATP结合盒转运体G1(ABCG1)和B族I型清道夫受体(SR-BI)]在各组间的表达差异。结果与对照组相比,GCP组胆囊黏膜MUC1(3.40±0.70比0)、MUC5AC(1.50±0.53比0)、MUC6(4.70±0.48比0)、ABCG1(3.50±0.53比1.60±0.55)表达均增高,而SR-BI表达评分降低(1.70±0.48比3.40±0.55),差异均具有统计学意义(均P<0.001)。与对照组相比,GCC组胆囊黏膜MUC1(4.80±0.42比0)、MUC5AC(4.70±0.48比0)、MUC6(3.30±0.67比0)、ABCG1(3.40±0.52比1.60±0.55)表达均增高,而SR-BI表达评分降低(0比3.40±0.55),差异均具有统计学意义(均P<0.001)。结论MUC1、MUC5AC、MUC6与RCT蛋白的不同表达程度,导致了在胆汁高胆固醇这一共同致病基础上GCP与GCC的差异化形成。Objective To explore the pathogenesis of gallbladder cholesteryl polyps(GCP)and gallbladder cholesterol calculus(GCC)by studying the different changes of mucin(MUC)expression and reverse cholesterol transporter(RCT)in gallbladder mucosa epithelium.Methods The data of 10 GCP patients(GCP group),10 GCC patients(GCC group)and 5 patients with normal gallbladder resection(control group)were retrospectively analyzed,who underwent cholecystectomy in the Department of General Surgery,Xuanwu Hospital,Capital Medical University from January to December 2021.Among the 10 patients in the GCP group,there were 5 males and 5 females,aged(43.40±9.59)years old.Among the 10 patients in the GCC group,5 males and 5 female,aged(45.00±8.13)years old.Among the 5 patients in the control group,there were 3 males and 2 females,aged(43.80±6.01)years old.Immunohistochemical analysis was used to investigate the expression differences of various subtypes of MUC and RCT[ATP binding cassette transporter G1(ABCG1)and B group type I scavenger receptor(SR-BI)]among each group.Results Compared with the control group,the expression of MUC1(3.40±0.70 vs.0),MUC5AC(1.50±0.53 vs.0),MUC6(4.70±0.48 vs.0),and ABCG1(3.50±0.53 vs.1.60±0.55)in the gallbladder mucosa of the GCP group increased,while the expression score of SR-BI decreased(1.70±0.48 vs.3.40±0.55),with statistical significance(all P<0.001).Compared with the control group,the expression of MUC1(4.80±0.42 vs.0),MUC5AC(4.70±0.48 vs.0),MUC6(3.30±0.67 vs.0),and ABCG1(3.40±0.52 vs.1.60±0.55)in the gallbladder mucosa of the GCC group increased,while the expression score of SR-BI decreased(0 vs.3.40±0.55),with statistically significant differences(all P<0.001).Conclusion The different expression levels of MUC1,MUC5AC,MUC6,and RCT proteins lead to the differential formation of GCP and GCC on the basis of the co-pathogenesis in high cholesterol in bile.

关 键 词：胆囊 胆固醇结石 胆固醇息肉 粘蛋白 胆固醇逆转运 机制 

分 类 号：R575.6[医药卫生—消化系统]