【摘要】：目的：通過(guò)嬰幼兒血管瘤、血管畸形和正常皮膚組織中的白血病抑制因子受體(LIFR)表達(dá)水平的檢測(cè),初步探討LIFR在血管瘤增生、消退中的可能作用及機(jī)制,為探尋血管瘤新的治療方法開(kāi)辟新途徑。方法：83例研究標(biāo)本為瀘州醫(yī)學(xué)院附屬院手術(shù)切除的血管疾病病理組織及兒童正常包皮。其中血管瘤52例,血管畸形16例,正常皮膚組織15例。按Mulliken標(biāo)準(zhǔn)進(jìn)行病理復(fù)檢：將血管瘤52例分為增生期血管瘤30例(A組),消退期血管瘤22例(B組)。應(yīng)用S-P免疫組織化學(xué)方法檢測(cè)LIFR與CD133、ki67在不同組別的血管瘤、血管畸形和正常皮膚組織中的表達(dá)水平。根據(jù)染色強(qiáng)度和陽(yáng)性細(xì)胞百分率兩項(xiàng)指標(biāo)的積分?jǐn)?shù)將免疫組化結(jié)果分為陰性(-)、弱陽(yáng)性(+)、強(qiáng)陽(yáng)性(++)3級(jí)。所有資料應(yīng)用SPSS17.0進(jìn)行統(tǒng)計(jì)分析,P0.05認(rèn)為具有顯著性差異。結(jié)果：1、LIFR陽(yáng)性表達(dá)為血管內(nèi)皮細(xì)胞胞膜和胞漿出現(xiàn)大量棕黃色顆粒。血管瘤增生期陽(yáng)性率為76.67%(23/30)；消退期陽(yáng)性率為31.82%(7/22),兩者的差異有統(tǒng)計(jì)學(xué)意義(X2=10.459,P0.05)。血管畸形組及正常皮膚組織陽(yáng)性表達(dá)率分別為25%(4/16)和20%(3/15)。血管瘤增生期與消退期、血管畸形以及正常皮膚組織比較,差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。2、CD133強(qiáng)陽(yáng)性表達(dá)為血管內(nèi)皮細(xì)胞胞膜及胞漿有大量的棕黃色顆粒。增生期血管瘤陽(yáng)性率表達(dá)為60%(18/30)；消退期血管瘤和血管畸形陽(yáng)性表達(dá)率分別為9.09%(2/22)和6.25%(1/16)；增生期與消退期比較,兩者的差異有統(tǒng)計(jì)學(xué)意義(X2=13.898,P0.05)。3、Ki67陽(yáng)性表達(dá)為血管內(nèi)皮細(xì)胞核內(nèi)有大量的棕黃色顆粒。增生期血管瘤陽(yáng)性表達(dá)率為86.67%(26/30),消退期血管瘤陽(yáng)性表達(dá)率為27.27%(6/22),兩者的差異有統(tǒng)計(jì)學(xué)意義(X2=9.816,P0.05)。血管畸形和正常皮膚中偶爾可見(jiàn)少數(shù)棕黃色顆粒,Ki67表達(dá)極弱或不表達(dá)。4、LIFR在血管瘤中的表達(dá)與CD133和Ki-67表達(dá)具有相似特點(diǎn),強(qiáng)陽(yáng)性表達(dá)主要在6月齡以下增殖期血管瘤,弱陽(yáng)性表達(dá)主要在6月齡以上增殖期血管瘤和消退早期血管瘤標(biāo)本。52例血管瘤檢測(cè)中LIFR與CD133的表達(dá)同時(shí)呈強(qiáng)陽(yáng)性者8例,同為弱陽(yáng)性6例,同為陰性20例；LIFR與Ki67的表達(dá)同時(shí)呈強(qiáng)陽(yáng)性者11例,同為弱陽(yáng)性9例,同為陰性17例；經(jīng)相關(guān)性分析,LIFR在血管瘤中的表達(dá)與CD133和Ki-67的表達(dá)均呈正相關(guān)關(guān)系,相關(guān)系數(shù)分別為0.63和0.787(P0.01)。結(jié)論：1、LIFR的表達(dá)與血管瘤增殖與退化過(guò)程有著密切的關(guān)系。2、CD133表達(dá)陽(yáng)性的內(nèi)皮祖細(xì)胞參與血管瘤的發(fā)生與發(fā)展過(guò)程。3、LIFR、CD133與Ki-67三者在小兒血管瘤的發(fā)生、發(fā)展過(guò)程中可能具有相互誘導(dǎo)、調(diào)節(jié)、協(xié)同作用。LIFR、CD133、Ki-67等指標(biāo)的檢測(cè)將有助于全面反映細(xì)胞增殖、分化程度,準(zhǔn)確判斷兒童血管瘤分類、分期。4、LIFR對(duì)嬰幼兒血管瘤增生與退化的具體作用及調(diào)節(jié)機(jī)制的深入研究將為探尋血管瘤新的治療方法提供新思路。
[Abstract]:Objective: to explore the possible role and mechanism of LIFR in proliferation and regression of hemangioma by detecting the expression of leukemia inhibitory factor receptor (LIFR) in infant angioma, vascular malformation and normal skin tissue. It opens up a new way to explore a new treatment method for angioma. Methods: 83 cases of vascular diseases were resected from the affiliated Hospital of Luzhou Medical College and normal foreskin in children. There were 52 cases of angioma, 16 cases of vascular malformation and 15 cases of normal skin tissue. According to Mulliken standard, 52 cases of angioma were divided into three groups: 30 cases (group A) and 22 cases (group B). The expression of LIFR and CD133,ki67 in different groups of angiomas, vascular malformations and normal skin tissues was detected by S / P Immunohistochemical method. According to the score of staining intensity and percentage of positive cells, the results of immunohistochemistry were divided into three grades: negative (-) and weakly positive (), (). All the data were statistically analyzed by SPSS17.0, and there was significant difference between the two groups. Results: 1 the positive expression of LIFR was a large number of brownish yellow particles in the membrane and cytoplasm of vascular endothelial cells. The positive rate of hemangioma was 76.67% (23 / 30) in proliferative phase, 31.82% (7 / 22) in involutional phase, and the difference was statistically significant (X2 / 10.459, P0.05). The positive rates of hemangioma in proliferative phase were 76.67% (23 / 30) and 31.82% (7 / 22) respectively. The positive expression rates of vascular malformation group and normal skin tissue were 25% (4 鈮，

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