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目的:探讨环氧合酶2(COX-2)与诱导型一氧化氮合酶(iNOS)在原发性翼状胬肉中的表达及其在发生发展过程中的作用。方法:原发性翼状胬肉组织与对照组的正常结膜组织标本均取自石河子大学第一附属医院眼科行手术治疗的患者,采用免疫组织化学Elivision法分别检测56例原发性翼状胬肉、20例正常结膜中COX-2、iNOS的表达;脱氧核苷酸末端转移酶介导的脱氧尿苷三磷酸末端标记法(terminal deoxynucleotidyl transferase mediated 2’-deoxyuridine 5’-triphosphate-biotin nick end labeling,TUNEL),检测不同时期原发性翼状胬肉细胞中凋亡细胞的表达。结果:56例原发性翼状胬肉中COX-2的阳性表达率,静止期为50%,进行期为87.5%,正常结膜为0(0/20)。iNOS的阳性表达率,静止期为50%,进行期为92.5%,正常结膜50%。COX-2、iNOS阳性表达在原发性翼状胬肉与正常结膜两组间差异有显著意义,P<0.001。正常结膜对照组无凋亡细胞表达,静止期和进行期胬肉组织中均出现凋亡细胞,凋亡细胞的表达在静止期和进行期2组间的表达有明显差异(P<0.05))。结论:COX-2、iNOS在翼状胬肉中的表达,提示COX-2、iNOS可促进新生血管形成,可能与翼状胬肉的发生、发展以及术后复发有关,细胞凋亡在翼状胬肉的发生中起重要作用,COX-2、iNOS抑制剂以及细胞凋亡的调控可望成为降低翼状胬肉复发率新的依据。
Objective: To investigate the expression of cyclooxygenase 2 (COX-2) and inducible nitric oxide synthase (iNOS) in primary pterygium and its role in development. Methods: The normal conjunctiva tissues from the primary pterygium and the control group were obtained from patients undergoing ophthalmologic surgery in the First Affiliated Hospital of Shihezi University. Fifty-six cases of primary pterygium were detected by Elivision immunohistochemistry. 20 cases of normal conjunctiva COX-2, iNOS expression; deoxynucleotidyl transferase mediated deoxyuridine triphosphate terminal deoxynucleotidyl transferase 2’-deoxyuridine 5’-triphosphate-biotin nick end labeling TUNEL) was used to detect the expression of apoptotic cells in primary pterygium cells at different stages. Results: The positive expression rates of COX-2 in 56 patients with primary pterygium were 50% in stationary phase, 87.5% in chronic phase and 0 (0/20) in normal conjunctiva. The positive rate of iNOS was 50% in quiescent period, 92.5% in duration, and 50% in normal conjunctiva. COX-2, iNOS positive expression in the primary pterygium and normal conjunctiva significant difference between the two groups, P <0.001. There were no apoptotic cells in the normal conjunctiva control group, apoptotic cells appeared in the pterygium of quiescent period and in the period of operation, the expression of apoptotic cells was significantly different between the two groups (P <0.05) . CONCLUSIONS: The expression of COX-2 and iNOS in the pterygium suggests that COX-2 and iNOS may promote neovascularization, which may be related to the occurrence and development of pterygium and the recurrence after surgery. The apoptosis in the pterygium Play an important role in the occurrence, COX-2, iNOS inhibitors and apoptosis regulation is expected to become a new basis for reducing the recurrence rate of pterygium.