【摘要】 目的:观察脑动静脉血管畸形发生发展过程中血管生成因子的作用。方法:收集天津医科大学总医院神经外科1999-08/2001-05手术切除的完整脑动静脉畸形新鲜标本47例(SpetzlerⅠ～Ⅴ级),其中以出血为首发症状者28例,癫痫5例,头痛7例,局灶性神经功能缺失7例;另取外伤内减压术切除的正常脑组织8例作为对照。采用免疫组化方法检测脑动静脉血管畸形标本中血管内皮细胞生长因子、Tie受体、血管生成素1、血管生成素2、原癌基因c-myc和增殖细胞核抗原的表达情况。结果:脑动静脉血管畸形标本中血管内皮细胞表达极低水平的Tie受体1和血管生成素1,但血管内皮细胞生长因子、Tie受体2、血管生成素2、c-myc和增殖细胞核抗原表达上调,并随脑动静脉血管畸形的Spetzler-Martin分级升高而递增,与对照组比较差异有显著性(P<0.05),其中血管内皮细胞生长因子与c-myc和增殖细胞核抗原表达呈正相关(r=0.728～0.916,P<0.05)。出血组较未出血组血管内皮细胞生长因子、血管生成素2和增殖细胞核抗原表达显著降低(P<0.05)。结论:血管生成因子表达与脑动静脉血管畸形发展扩大和破裂出血有重要关系,血管内皮细胞生长因子可能通过上调c-myc表达而发挥促血管生成的生物学效应。更多还原

【Abstract】 AIM: To investigate the action of angiogenesis factor in the occurrence and development process of cerebral arteriovenous malformation (cAVM).METHODS: Forty-seven fresh specimens of intact resection with cAVM(Spetzler GradeⅠ-Ⅴ) were selected from Department of Neurosurgery, General Hospital of Tianjin Medical University between August 1999 and May 2001. The initial symptom included hemorrhage in twenty-eight cases, epilepsy in five cases, headache in seven cases and focal neurological afunction in seven cases, while eight cases of normal brain tissue, which was excised from trauma by decompression, were taken as control. The expression of vascular endothelial growth factor (VEGF), Tie receptor, angiogenin-1 (Ang1), angiogenin-2 (Ang2), proto-oncogene c-myc and proliferating cell nuclear antigen (PCNA) in cAVM specimens were detected with immunohistochemistry. RESULTS: There was very low expression of Tie1 and Ang1 in cAVM endothelial cells, while the expression of VEGF, Tie2, Ang2, PCNA and c-myc upregulated, and increased correspondingly with the Spetzler-Martin Grade of cAVM. Difference was significant between cAVM specimens and normal controls (P < 0.05). The expression of VEGF had positive correlation with that of c-myc and PCNA (r=0.728-0.916,P < 0.05). However, the expression of VEGF, Ang2 and PCNA decreased significantly in hemorrhage group compared with non-hemorrhage group (P < 0.05). CONCLUSION: The expression of angiogenesis factor plays an important role in the development and hemorrhage of cAVM, and VEGF might have biological effect through upregulating the c-myc expression so as to promote angiogenesis.更多还原