血管硬化性病变与肝癌自发性破裂的关系

目的 探讨血管壁弹性变化与肝癌自发性破裂的相关关系。方法 选用肝癌破裂及未破裂患者的肝癌组织标本各30例，采用免疫组化ABC法及电子显微镜检测其与血管病变有关的因素：第八因子相关抗原因子(vWF因子)、弹性硬蛋白、弹性蛋白酶(中性粒细胞性)。结果与未破裂组相比，肝癌破裂患者中血管内皮vWF因子表达量明显下降，小动脉壁中弹性蛋白酶分布异常、弹性硬蛋白增生过度、弹力膜断裂。vWF因子为血管受损指标之一，并参与凝血过程。上述病变的结果，导致患者小动脉壁脆性增加及凝血功能下降，稍遇外力的作用即易发生血管破裂，进而可导致肿瘤组织的破裂。结论肝癌患者体内的血管壁硬变可能与肝癌肿瘤破裂有关。

Vascular Elasticity in Patients with Spontaneous Rupture of Hepatocellular Carcinoma

Objective To investigate the relationship between changes of vascular elasticity and spontaneous rupture of hepatocellular carcinoma (HCC). Methods We examined the semi-quantitatively expression of related angiogenesis factors including von Willebrand factor, elastin and neutrophil elastase in 30 specimens of HCC with spontaneous rupture by immunohistochemistry compared with 30 specimens of HCC without rupture.Results The results showed that there was a significant decrease of von Willebrand factor, overproliferation of elastin and abnormal distribution of neutrophil elastase around the small artery in ruptured HCC. These changes exacerbated weakness of the blood vessels and destroyed function of coagulation. The blood vessels split easily when the vascular load increased from hypertension or minor mechanical trauma.Conclusion The spontaneous rupture of HCC may be related to the vascular dysfunction.