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目的研究鼻息肉及鼻内镜术后2周紧邻术区鼻黏膜中血管细胞黏附分子(VASCULARCELL ADHESION MOLECULE,VCAM)-1、嗜酸粒细胞亲合素(EOTAXIN)及血管内皮生长因子(VASCULARENDOTHELIAL GROWTH FACTOR,VEGF)的表达及相关性,探讨鼻息肉术后复发的可能机制。方法应用链霉亲和素-过氧化物酶(SABC)免疫组化法检测30例鼻息肉及其中22例鼻内镜术后2周患者紧邻术区鼻黏膜的VCAM-1、EOTAXIN和VEGF的表达情况;HE染色光镜下观察组织结构、炎性细胞浸润情况。结果①HE染色可见鼻息肉组织嗜酸粒细胞大量浸润,术后则明显减少(T=2·891,P<0·05);②VCAM-1在鼻息肉手术前后均呈阳性表达,阳性面积差异无统计学意义(T=-2·051,P>0·05),平均吸光度术后减弱(T=3·670,P=0·05);EOTAXIN手术前后阳性面积差异无统计学意义(T=0·739,P>0·05),平均吸光度术后明显减弱(T=4·428,P<0·05),EOTAXIN术后腺体阳性率明显增加(T=-2·899,P<0·05);③VEGF阳性面积及平均吸光度手术前后表达差异均无统计学意义(T值分别为-0·037、0·825,P值均>0·05)。结论①鼻息肉鼻内镜手术后嗜酸粒细胞数量明显减少,说明紧邻术区水肿状组织不同于鼻息肉。②VCAM-1、EOTAXIN术后紧邻术区鼻黏膜阳性表达,说明EOTAXIN有可能上调VCAM-1在血管内皮的表达,促进嗜酸粒细胞黏附于内皮细胞,穿内皮细胞间隙迁移到组织中,可能是息肉复发的基础。其中EOTAXIN术后腺体阳性表达明显增加,推测其可能在鼻息肉复发早期发挥重要作用。③VEGF术后高表达,提示VEGF可促进术区血管增生及通透性增强,使局部组织增生、水肿,从而可能成为息肉复发过程中的重要因素之一。
Objective To investigate the relationship between nasal polyps and nasal polyps and the nasal mucosa of nasal polyps and nasal endoscopy in the immediate vicinity of the operative area.Methods The nasal polyps and nasal polyp were treated with VASCULARELLA MOLECULE (VCAM) -1, EOSTAXIN and VASCULAR ENDOTHELIAL GROWTH FACTOR, VEGF) and investigate the possible mechanism of postoperative recurrence of nasal polyps. Methods 30 cases of nasal polyps and 22 cases of nasal polyps were examined by streptavidin-peroxidase (SABC) immunohistochemistry. The expressions of VCAM-1, EOTAXIN and VEGF Expression; HE staining under light microscopy of tissue structure, inflammatory cell infiltration. Results (1) HE staining showed a significant infiltration of eosinophils in nasal polyps and a significant decrease after operation (T = 2.891, P <0.05). ②VCAM-1 was positive in nasal polyps before and after surgery, The statistical significance (T = -2.051, P> 0.05) showed that the mean absorbance decreased after operation (T = 3.70, P = 0.05). There was no significant difference in the positive area before and after EOTAXIN operation (T = 0.779, P> 0.05). The mean absorbance decreased significantly after operation (T = 4.428, P <0.05), and the positive rate of EOTAXIN increased significantly after operation (T = -2.899, P < 0.05). (3) There was no significant difference in the positive area and average absorbance of VEGF between before and after operation (T values were -0.037,0.825, P> 0.05). Conclusions ① The number of eosinophils in nasal polyps after endoscopic sinus surgery is significantly reduced, indicating that the eyelid tissue adjacent to the operative area is different from nasal polyps. ② Positive expression of VCAM-1 and EOTAXIN in the nasal mucosa immediately after operation showed that EOTAXIN may up-regulate the expression of VCAM-1 in the vascular endothelium and promote the adherence of eosinophils to endothelial cells and the migration of endothelial cells to the tissues, which may be The basis of polyps recurrence. EOTAXIN postoperative gland positive expression was significantly increased, suggesting that it may play an important role in early nasal polyps recurrence. ③EGEGF high expression, suggesting that VEGF can promote vascular hyperplasia and permeability increased, so that local tissue proliferation, edema, which may become one of the important factors in polyp recurrence.