【作者】 陈瑶；

【导师】 罗成群；

【作者基本信息】 中南大学 ， 烧伤整形外科， 2009， 硕士

【摘要】 目的:通过研究铜针留置前后血管瘤组织的病理变化,及MMP-2,MMP-9,TGF-β1的表达差异与血管瘤增生退化之间的关系,进一步探讨铜针留置治疗血管瘤的机制,为血管瘤及其它肿瘤血管性疾病的治疗提供理论依据。方法:①血管瘤患者符合铜针治疗适应症的行铜针治疗②选工业用直径3mm,长3-10cm铜丝,一端打磨成尖,另一端弯成圆形的铜针,灭菌备用。所有患者均在麻醉下行瘤体局部留置铜针治疗,留置铜针16～45枚,留置时间为1周③治疗前后均在患者知情同意下留置标本④按Mulliken分类标准复检共增生期血管瘤6例,男2例,女4例,年龄4～18岁,平均年龄8.5±5.5岁。⑤OLYMPUS光学显微镜下观察(x400)治疗前后组织病理变化⑥免疫组织化学方法检测铜针留置前后组织MMP-2,MMP-9,TGF-β1表达情况,图像分析并统计铜针治疗前后组织因子表达差异。结果:1组织病理学变化治疗前瘤体组织血管部分呈囊状不规则扩张,管腔大小不一,内衬内皮细胞显著增生,部分血管内皮细胞呈胖梭形,围绕官腔不明显的血管腔隙,有多层基底膜,细胞间结缔组织极少;治疗后多数样本组织血管管腔明显缩小变窄,甚至闭塞,管壁萎缩,原官腔被大量纤维组织取代。2 MMP-2在血管瘤组织中强表达,在铜针治疗后血管瘤组织中表达极弱,两者比较有显著性差异(P＜0.05);MMP-9在铜针治疗前血管瘤组织中强表达,而铜针治疗后血管瘤组织中表达极弱,两者比较有显著性差异(P＜0.05);TGF-β在铜针治疗前血管瘤组织中低表达,铜针治疗后血管瘤组织中极低表达,两者比较无显著性差异(P＞0.05)。结论:1铜针留置治疗血管瘤可使血管发生萎缩甚至闭塞,纤维化等变化而加速血管瘤的退化。2铜针留置前后MMP-2,MMP-9在血管瘤组织的表达有显著性差异,铜针可能通过干预MMP-2,MMP-9等相关因子的表达而加速血管瘤的退化。更多还原

【Abstract】 Objective To investigate the effect of copper needles retained in hemangioma on the expression of MMP-2,MMP-9 and TGF-β1 as well as histological and pathological changes of the neoplasm,and to make Further understanding of the therapeutical mechanism of the copper needle which may provide the theoretical evidence to cure the hemangioma and(or) other neoplastic and vascular diseases.Methods①The patient with hemangioma was treated by copper needle puncturing.②The copper needles,ranging from 3cm to 10cm in length with a blunt point and a circularity end ,which were made of industrial copper wire with diameter 3mm were sterilized before use.all case were retained 16-45 copper needles in the local hemangioma under anaesthesia for one week .③To detain the hemangiomatous sample before and after the treatment, all cases understood and agreed to their treatments.④Choose the hemangioma in proliferated period (n=6) according to Mulliken standard under microscope: including 2 males and 4 females, from 4-18 years old ,average age 8.5±5.5years old⑤The histological and pathological changes were observed under Olympus light microscope.(x400)⑥MMP-2,MMP-9,TGF-β1 were detected by immunohistochemical method,and to compare the difference of measurement data after the treatment with that before. Result1 Histological and pathological changes:before treatment, some blood vessels of neoplasm presented universally irregular and cystoid distention with varied diameter and high proliferative endothelial cells, some vascular endothelial cells of fat clostridial form surround the blood vessels without apparent lumina, little connective tissue and multi-layer basement could be seen. However, dwinding and occlusion of blood vessel appeared in most specimens after copper needles trantment , associate with atrophic vessel wall and fibrosis.2 The expression intensity of MMP-2,MMP-9 in pretherapy group were markedly higher than that in post-treatment group,the difference were significant(P<0.05). However,the expression intensity of TGF-β1 in pretherapy group was weak,and nearly the same as the post-treatment group,no significant difference was found(p>0.05).Conclusion1 The treatment of copper needle puncturing can make the blood vessels of hemangioma shrink back、fibration、even emphraxis2 The expression intensity of MMP-2,MMP-9 in pretherapy group were markedly higher than that in post-treatment group,the difference were significant ,The copper needle is likely to interfer in the expressions of MMP-2,MMP-9 and(or) some other related factors to accelerate the degeneration of hemangioma更多还原