巨噬细胞和淋巴细胞及增殖细胞核抗原在鼻息肉组织中的表达及病理学意义

目的　研究巨噬细胞 (CD68)、T细胞 (CD45RO)、B细胞 (CD2 0 )和增殖核细胞核抗原(proliferatingcellnuclearantigen ,PCNA)在鼻息肉组织中的表达。方法　应用免疫组化链霉菌抗生物素蛋白过氧化酶 (strept avidinoxidase,SP)法对 50例鼻息肉分别做CD2 0、CD45RO、CD68、PCNA的免疫组化染色 ,结合常规HE染色切片进行分析。结果　①CD68+ 细胞在嗜酸性粒细胞性鼻息肉较嗜中性粒细胞性鼻息肉表达率高 ,差异具有显著性意义 (P <0 0 5) ;②CD45RO、CD2 0在鼻息肉均有阳性表达 ,CD45RO与CD2 0呈负相关 (P =0 0 5) ;③CD68阳性细胞与嗜酸性粒细胞浸润及鼻息肉上皮PCNA阳性表达有相关性 (P <0 0 5)。鼻息肉上皮的PCNA阳性表达和成纤维细胞PCNA阳性表达有相关性 ,(P <0 0 5)。结论　鼻息肉的形成与炎性细胞浸润密切相关。鼻黏膜局部的细胞免疫与体液免疫异常导致上皮细胞、成纤维细胞增殖、腺体增生是鼻息肉发生的基础 ,CD68+ 细胞可能是鼻息肉中的炎性干细胞     

影响鼻息肉手术疗效的相关因素探讨

目的：探讨鼻息肉的不同组织病理学表现与经内镜手术疗效的关系。方法：通过对鼻息肉常规病理分析，及CD20、CD45、RO、CD68、增殖细胞核抗原的免疫组化染色结果，结合临床资料及术后随访资料，应用SPSS10．0统计软件中的秩和检验、非参等级相关性检验，极大似然比后退法进行Logistic回归分析。结果：单因素分析只有CD68^ 、鼻息肉总积分对治愈率有显著影响。多因素分析CD68^-、鼻息肉总积分和淋巴细胞、嗜酸性粒细胞浸润程度与手术疗效有显著相关性。结论：伴有腺体增生的鼻息肉其总积分、嗜酸性粒细胞、淋巴细胞、CD68^-细胞浸润程度可作为鼻息肉患者预后是否容易复发的指标。     

鼻息肉组织中炎性细胞的病理学意义

研究鼻息肉组织中炎性细胞的病理意义。方法对１０例正常鼻粘膜和２４例鼻息肉组织行免疫组化及ＭＧＧ染色以观察嗜酸性粒细胞,单核细胞,巨噬细胞在组织中的分布程度,结果：鼻息肉组织中嗜酸性粒细胞,ＣＤ６８阳性巨噬细胞和单核细胞显著增加。结论：鼻息肉的发生与炎性细胞的浸润,活化密切相关,药物治疗应是鼻息肉病治疗中的一个重要方面。     

CD45RO CD20及总IgE在声带息肉组织中表达的研究

目的 :从免疫病理学角度探讨细胞免疫、体液免疫和局部变态反应在声带息肉发病中的作用。方法 :对 30例声带息肉组织 (息肉组 )和 10例正常声带组织 (对照组 )采用免疫组织化学方法观察两组CD4 5RO、CD2 0及IgE的表达情况并检测其阳性细胞数。 结果 :息肉组CD4 5RO、CD2 0和IgE阳性细胞数显著高于对照组 (P <0 .0 1) ;声带息肉组织中CD4 5RO、CD2 0和IgE的表达之间无相关性 ;男、女患者间的表达差异亦无统计学意义 (P >0 .0 5 )。 结论 :由T淋巴细胞介导的细胞免疫和B淋巴细胞介导的体液免疫在声带息肉中免疫应答活跃 ;声带黏膜局部变态反应参与了声带息肉的发病 ;在声带息肉的发病机制中免疫病理改变起着重要的作用。     

Expression of cell proliferation and apoptosis gene associated protein on nasal polyps and its significance]

OBJECTIVE: To further understand the pathogenic mechanism of nasal polyps, namely the cells proliferation and apoptosis in nasal polyps tissue. METHODS: The proliferation cell nuclear antigen (PCNA), apoptosis associated gene protein (Bcl-2, Bax) were determined in 26 tissue samples of nasal polyps and 14 controls from normal inferior turbinates respectively. RESULTS: (1) The positive expression e of PCNA, Bcl-2 and Bax were significantly higher in epithelium of nasal polyps than the controls, and the expression rate of Bcl-2/Bax, however, tended equipoise. (2) The expression of Bcl-2 were significantly stronger than Bax in glands, eosinophils of nasal polyps tissue, and there were not significant differences in inferior turbinates. CONCLUSION: There is strongly proliferation activity in the epithelium of nasal polyps, and expression imbalance of Bcl-2/Bax may be one of the important factors of eosinophilia in nasal polyps tissue.     

The concentration and expression of IL-5 in human nasal polyp tissue]

OBJECTIVE: To study the concentration and expression of IL-5 in nasal polyp tissues and explore its significance in the micro-environment differentiation of eosinophils accumulation and clarify the conception of nasal polyposis. METHODS: The concentration and expression of IL-5 in nasal polyp tissues of 40 patients were determined by ELISA and immunohistochemistry, and inferior turbinate mucosa from patients with nasal polyps and healthy volunteers was used as control. RESULTS: 1. IL-5 concentration in the polyp tissues was significantly higher than that in inferion turbinate mucosa(P < 0.05). There was no significant difference in inferion turbinate mucosa between the patients with nasal polyps and healthy volunteers (P > 0.05). IL-5 concentration in polyp tissues was markedly higher in patients with extensive polypoid change of nasal mucosa, history of previous polypectomy and allergic rhinitis compared with those without these features (P < 0.05). IL-5 concentration had no correlation with age and sex (P > 0.05). 2. 80.1% of the eosinophils were positive for IL-5 and 90.9% of IL-5 positive cells were eosinophils. Only 3.7% of the lymphocytes and neutrophils were IL-5 positive, and IL-5 was not detectable in epithelial cells. IL-5 expression in eosinophils of polyp tissues was remarkably stronger than that of the turbinate mucosa (P < 0.05). There was no significant difference in inferion turbinate mucosa between the patients with nasal polyps and healthy volunteers (P > 0.05). IL-5 expression of eosinophils in polyp tissues was significantly stronger in patients with extensive polypoid change of nasal mucosa, history of previous polypectomy and allergic rhinitis compared with those without these features (P < 0.05). There was no significant difference in IL-5 expression in lymphocytes and neutrophils between polyp tissues and inferior turbinate nasal mucosa (both P > 0.05). CONCLUSION: IL-5 is a key protein in eosinophilic pathologic mechanisms in nasal polyp tissues.     

CD137在鼻息肉嗜酸粒细胞中的表达及意义

目的了解CD137在鼻息肉(NP)组织浸润的炎性细胞中的表达及分布情况,研究CD137与嗜酸粒细胞(EOS)积聚及与NP病变范围的关系,探讨其在炎症反应和在NP生长中的作用.方法选择NP住院手术患者44例,按慢性鼻窦炎鼻息肉临床分型分期标准分为A、B两组;选择因鼻中隔偏曲而行下鼻甲部分切除的标本11例作为对照组.采用免疫组织化学染色法对息肉石蜡切片进行CD137染色,对其染色情况进行观察.结果CD137阳性染色可见于EOS、淋巴细胞、中性粒细胞等炎性细胞中,为胞膜染色;CD137阳性染色A、B两组之间差异具有统计学意义(P<0.01).结论CD137可在NP组织的EOS、淋巴等细胞中表达,与NP组织的EOS化和病变范围相关,可能参与炎症反应,影响EOS释放炎性递质及细胞因子的释放而在NP生长中起重要作用.     

STAT6在鼻息肉组织中的表达及其与嗜酸粒细胞浸润的关系

目的：研究信号转导和转录激活因子6（STAT6）在鼻息肉组织中的表达及其对嗜酸粒细胞（EOS）浸润聚集的作用,探讨其在鼻息肉发生中的可能作用。方法：选取符合纳入标准的鼻息肉患者手术切除标本（鼻息肉组）30例和同期单纯行鼻中隔偏曲矫正术中切除的下鼻甲组织（对照组）10例。采用免疫组织化学SP法检测2组下鼻甲黏膜中STAT6的表达。应用SPSS13.0软件进行统计学分析。结果：STAT6和EOS在鼻息肉组织中的表达明显高于下鼻甲,差异有统计学意义（P〈0.05）。STAT6阳性细胞主要集中于鼻息肉的上皮细胞、腺体细胞和组织中浸润的炎性细胞的细胞质中。鼻息肉组中STAT6的表达与EOS浸润程度一致（P〈0.01）。结论：STAT6在鼻息肉组织中的高表达及其对EOS浸润聚集的作用,可能与鼻息肉的发生和发展关系密切。     

Eotaxin-1在真菌球型鼻-鼻窦炎合并鼻息肉中的表达与嗜酸性粒细胞浸润的相关性

目的观察真菌球型鼻-鼻窦炎合并鼻息肉的组织病理学特点,检测Eotaxin-1在真菌球型鼻-鼻窦炎合并鼻息肉中的表达及与嗜酸性粒细胞浸润的相关性,探讨Eotaxin-1在真菌球型鼻-鼻窦炎合并鼻息肉发病过程中的作用。方法收集真菌球型鼻-鼻窦炎合并鼻息肉20例和鼻中隔偏曲矫正术患者代偿性肥大的下鼻甲黏膜15例,用HE染色法观察组织中的嗜酸性粒细胞浸润,免疫组织化学法检测组织中Eotaxin-1的表达,比较两组之间的表达差异,分析组织中嗜酸性粒细胞浸润数目与Eotaxin-1表达的相关性。结果①真菌球型鼻-鼻窦炎合并鼻息肉上皮脱落、鳞状上皮化生现象明显,间质为大量疏松结缔组织,其中可见较多的淋巴细胞、嗜酸性粒细胞和巨噬细胞浸润及大量的毛细血管增生,有时可见较多的纤维组织增生,黏膜内未见真菌菌丝和孢子;②Eotaxin-1在下鼻甲黏膜上皮细胞中有少量表达,真菌球型鼻-鼻窦炎合并鼻息肉表达Eotaxin-1明显增多（P＜0.05）,主要由上皮细胞和血管内皮细胞分泌,间质中可见嗜酸性粒细胞和巨噬细胞表达Eotaxin-1;③组织中嗜酸性粒细胞浸润数目和Eotaxin-1的表达明显相关（P＜0.05）。结论真菌球型鼻-鼻窦炎合并鼻息肉组织呈慢性炎症改变,其中可见较多的嗜酸性粒细胞浸润,真菌可能通过介导Eotaxin-1的过量表达,引起嗜酸性粒细胞聚集活化增多,是真菌球型鼻窦炎合并鼻息肉发生的重要因素之一,拮抗Eotaxin-1发挥功能可能对其临床防治有意义。     

Inflammatory cells in nasal mucosa and nasal polyps

OBJECTIVE: Since some controversy exists concerning the frequency of inflammatory cells in nasal polyps, we have compared the frequency of tissue inflammatory cells (lymphocytes, neutrophils, eosinophils and plasma cells) including 11 kinds of lymphocyte subsets in the same specimens of nasal mucosa and nasal polyps. METHODS: Histopathological observations and flow cytometric analyses were performed on eight mucosal specimens of the inferior turbinates of patients with nasal polyps and on 13 polyp specimens. RESULTS: Nasal polyps contained significantly more eosinophils, neutrophils and plasma cells than nasal mucosa, and EG2+ cells (activated eosinophils) were significantly more frequent in nasal polyps than in nasal mucosa. Flow cytometric analysis showed that there were no significant differences in the frequencies of lymphocytes and lymphocyte subsets (CD1+, CD2+, CD3+, CD5+, CD7+, CD4+, CD8+, CD10+, CD19+, CD20+ and HLA-DR+ cells) including CD4/8 ratios between nasal mucosa and polyps, though, both nasal mucosa and polyps contained significantly more lymphocytes than eosinophils, neutrophils or plasma cells. The T cell lineage (CD2+, CD3+, CD5+ and CD7+ cells) was found in high frequency and B cell lineage (CD10+, CD19+ and CD20+ cells) in low frequency in both nasal mucosa and polyps. The frequency of HLA-DR+ cells (most of which were activated T cells) was not significantly different between nasal mucosa and nasal polyps. CONCLUSION: Histopathological and flow cytometric analyses were performed on the composition of inflammatory cells in nasal mucosa of the inferior turbinates and in polyps from the same patients. The elevated numbers of activated eosinophils, neutrophils and plasma cells in nasal polyps compared with nasal mucosa suggest that inflammatory processes play important roles in the pathophysiology of nasal polyps. The frequencies of lymphocytes and lymphocyte subsets were not significantly different between these two tissues.     

Activated eosinophils in nasal polyps: a comparison of asthmatic and non‐asthmatic patients

Objectives: There is a recognized clinical association between nasal polyps and asthma. Nasal polyps and the airways of asthmatic patients demonstrate marked eosinophilia suggesting that this inflammatory cell may have a key role to play in both conditions. The objective of this study was to determine whether nasal polyps from patients with asthma had a greater density of activated eosinophils than patients with no associated respiratory disease. Design: Archived specimens were retrieved from patients who had undergone nasal polyp surgery and their case notes reviewed. Activated eosinophils were identified using immunohistochemistry for a monoclonal antibody to secreted eosinophil cationic protein (EG2). Setting: Teaching hospital otolaryngology unit. Participants: Consecutive patients who had undergone nasal polyp surgery in 1994 were recruited. The diagnosis of asthma was based on a documented physician diagnosis and appropriate drug treatment. Twenty‐four asthmatic and 35 non‐asthmatic patients were studied. Main outcome measures: Eosinophil density was measured using a standardized counting technique. Results: Asthmatic patients were significantly more likely to have had previous polyp surgery (chi‐square test: P < 0.05). Areas of intense eosinophilia were identified in all samples. There was a significant greater degree of activated eosinophilia in the asthmatic patients (t‐test: P < 0.05). Conclusions: We have demonstrated a higher number of previous operations in asthmatic patients, and also a greater degree of activated eosinophilia in asthmatic polyps compared with non‐asthmatics. This would suggest that eosinophil activity has a role to play in the pathogenesis of nasal polyps.     

The expression of transforming growth factor alpha and its receptor in nasal polyps]

OBJECTIVE: To assess the possible role of expression of TGF alpha and EGFR in nasal polyps and its relationship with PCNA labeling index. METHOD: Specimens from 20 patients of nasal polyps were studied with immunohistochemical technique. RESULT: The expression of TGF alpha, EGFR and PCNA were increased in the epithelium, gland cells and inflammatory cells of nasal polyps. There was a close correlation between the intensities of TGF alpha, EGFR and PCNA. CONCLUSION: TGF alpha may play a key role in epithelial cell proliferation in nasal polyps.     

鼻息肉中CD34的表达及其与嗜酸粒细胞浸润的关系

目的 探讨CD34在人鼻息肉组织中的表达及其与嗜酸粒细胞浸润的关系。方法 采用HE和免疫组化ElivisionPlus二步法，检测30例正常下鼻甲，60例鼻息肉组织中CD34蛋白的表达情况，并对CD34阻性血管进行微血管（MVD））计数，了解微血管的分布及嗜酸粒细胞的浸润情况。结果 鼻息肉组织中CD34阳性表达广泛，正常下鼻甲组织中CD34呈散在的弱阳性表达；鼻息肉组织中MVD明显高于下鼻甲组织中MVD（P〈0．01），与嗜酸粒细胞的浸润具有正相关性。结论 CD34蛋白有可能介导嗜酸粒细胞的浸润，加重对鼻黏膜的损害。     

鼻息肉调节激活正常T细胞表达和分泌因子的测定及其意义

目的 探讨在鼻息肉形成过程中,上皮应答时产生调节激活正常Ｔ细胞表达和分泌因子（ｒｅｇｕｌａｔｅｄ ｕｐｏｎ ａｃｔｉｖａｔｉｏｎ,ｎｏｒｍａｌＴｃｅｌｌ ｅｘｐｒｅｓｓｅｄ ａｎｄ ｓｅｃｒｅｔｅｄ,ＲＡＮＴＥＳ）对嗜酸粒细胞趋化、移行、局部聚集的影响。方法 采用无血清原代细胞培养法培养鼾症患者下鼻甲上皮细胞和鼻息肉上皮细胞,经炎性介质ＩＬ－１β（２５ｕｇ／Ｌ,５０ｕｇ／Ｌ）刺激后收集２４ｈ和４８     

Roles of CD43, CD20 and local IgE in the pathogenesis of nasal polyps]

OBJECTIVE: To estimate the roles of CD43, CD20 and total IgE in the pathogenesis of nasal polyps. METHOD: Twenty-six cases of nasal polyps and 20 cases of mucosa of middle turbinates were used in present study. RESULTS: The number of CD43+ cells, CD20+ cells and plasma cells in nasal polyps were significantly more than that in middle turbinates (P < 0.01). The positive rate of local IgE+ cells in nasal polyps was significantly higher than in middle turbinate (P < 0.01). CONCLUSION: There were active cellular immunity and humoral immunity in nasal polyps. Local allergy may play a role in the pathogenesis of nasal polyps.     

白细胞介素-5与嗜酸性粒细胞阳离子蛋白在鼻息肉发病中的意义及相互关系

目的：探讨白细胞介素—5(IL—5)及嗜酸性粒细胞阳离子蛋白(ECP)在鼻息肉发病中的作用及相互关系。方法：采用pharmacia CAP荧光免疫系统和ELISA双抗体夹心法对30例鼻息肉患者(鼻息肉组)和8例鼻中隔偏曲或阻塞性睡眠呼吸暂停综合征(OSAS)患者(对照组)分别进行血清中ECP及组织匀浆中ECP、IL—5的检测。结果：鼻息肉组匀浆中IL—5的水平明显高于对照组，其差异有显著性意义(P＜0．05)；鼻息肉组血清与匀浆中的ECP含量明显高于对照组，其差异亦有显著性意义(P＜0．05)。鼻息肉组匀浆中IL—5与血清中ECP水平呈明显正相关(r＝0．598，P＜0．05)；与匀浆中的ECP水平也呈正相关(r＝0．451，P＜0．05)。结论：ECP是嗜酸性粒细胞活化的标志，也是导致鼻腔炎症发生的重要因子；IL—5在鼻息肉组织中高表达，并与血清和组织中ECP水平密切相关，共同促进鼻腔炎症过程的不断加重。     

鼻腔鼻窦内翻性乳头状瘤中增殖细胞核抗原和Bcl-2的表达及意义

目的检测、观察和对比鼻腔鼻窦内翻性乳头状瘤(sinonasal inverted papillomas,SNIP)增殖的上皮和鼻息肉(nasal polyps,NP)炎性上皮中细胞增殖和凋亡抑制的表达情况并分析其相关性,探讨细胞增殖和凋亡抑制在SNIP发生和发展中的作用及意义。方法 SNIP标本30例,均为初发病例;鼻内镜手术中所取NP标本15例,亦均为初发病例。用免疫组化法检测标本上皮中增殖细胞核抗原(proliferating cell nuclear antigen,PCNA)和Bcl-2的表达情况。结果在30例SNIP标本和15例NP标本中PCNA和Bcl-2均有表达,在SNIP标本中两者表达均高于15例NP标本(t=5.626,P=0.0001;t=2.539,P=0.011)。在SNIP标本中,细胞增殖与细胞凋亡抑制的表达呈正相关(r=0.53,P<0.005)。结论细胞增殖及凋亡抑制可能共同参与了SNIP的发生及发展。细胞增殖在SNIP的发生和发展中起主要的作用。相关分析显示PCNA与Bcl-2分别作为细胞增殖辅助因子和细胞凋亡的调控基因在SNIP的发生发展中可能具有一定的相关性。     

TNF-α及CD68在鼻息肉中的表达和意义

目的研究鼻息肉组织中肿瘤坏死因子α(tumornecrosisfactor,TNF-α)和CD68的表达及其相关性,探讨二者与鼻息肉发病机理的关系。方法分别以TNF-α和CD     

鼻息肉组织炎性细胞中血管通透性因子的表达

目的：探讨鼻息肉组织里程酸性粒细胞，巨噬细胞和浆细胞中血管通透性因子（VPF）的表达及意义。方法：12例鼻息肉标本行VPF的免疫组化染色，双重免疫酶染色以及免疫组化和MGG（may-grunwald giemsa)双重染色，光镜观察。结果：VPF在鼻息肉组织嗜酸性粒细胞，巨噬细胞及浆细胞中均有表达。结论：VPF可能是嗜酸性粒细胞，巨噬细胞及浆细胞发挥促息肉形成作用的途径之一。     

鼻息肉组织中T—细胞亚群的分布及2种白细胞介素表达？…

目的 探讨Ｔ－淋巴细胞及细胞因子白细胞介素（ｉｎｔｅｒｌｅｕｋｉｎ,ＩＬ）调节２功能的紊乱在鼻息肉发病中的重要作用。方法 应用免疫组织化学的方法检测３２例鼻息肉标本和６例下鼻甲粘膜对照标本中Ｔ－细胞亚群（ＣＤ＾＋４和ＣＤ＾＋８细胞）以及细胞因子ＩＬ－５、ＩＬ－１０阳性细胞的表达情况。并进行统计学分析。结果 鼻息肉组织中可见各种炎细胞浸润,ＣＤ＾＋４和ＣＤ＾＋８细胞数增多（Ｐ〈０．００１）;其中ＣＤ