TGF-β_1,TNF-α和MMP-9在人结核性淋巴结中的表达及临床意义

目的:探讨转化生长因子-β1(TGF-β1)、肿瘤坏死因子-α(TNF-α)和基质金属蛋白酶-9(MMP-9)在人结核性淋巴结中的表达及其临床意义。方法:应用免疫组化SP法检测TGF-β1、TNF-α和MMP-9在20例活动性淋巴结核(ATL)、20例陈旧性淋巴结核(OTL)2、0例慢性非特异性淋巴结炎(CNL)1、0例结节病淋巴结(SL)及10例正常淋巴结中的表达,应用图像分析技术对免疫组化结果进行定量分析。结果:TGF-β1、TNF-α和MMP-9在活动性淋巴结核组和陈旧性淋巴结核组均有表达,三者在活动性淋巴结结核的肉芽肿、坏死周围炎区呈强表达,慢性非特异性淋巴结炎组呈弱阳性表达。TGF-β1和MMP-9在结节病组呈中等度表达,而TNF-α在结节病组不表达。三者在正常淋巴结中不表达。三者的表达在活动性结核组显著高于陈旧性结核病灶组(P<0.05),非特异性淋巴结炎组(P<0.01)和结节病淋巴结组(P<0.05)。活动性结核组TGF-β1/TNF-α显著高于陈旧性结核病灶组(P<0.01)。结论:TGF-β1和MMP-9高表达可能参与结核性淋巴结炎发病机制,检测TGF-β1/TNF-α可能预测疾病的转归。

Expression of TGF-Beta1 ,TNF-Alpha, and MMP-9 in Tuberculous Lymphadenitis

Objective: To investigate the expression and their clinical significance of transforming growth factor-β1(TGF-β1),tumour necrosis factor-α(TNF-α) and matrix metalloproteinase-9(MMP-9) in tuberculous lymphadenitis.Methods: Immunohistochemical method of streptavidin-peroxidase(SP) was used to detect the expression of TGF-β1,TNF-α and MMP-9 proteins on the paraffin embedded sections from 20 active tuberculosis lymphadenitis,20 obsolete tuberculosis lymphadenitis,20 chronic nonspecific lymphadenitis and 10 sarcoidosis lymphadenitis.The immunohistochemical results were analyzed quantitatively using an image analysis system.Results: TGF-β1,TNF-α and MMP-9 were strongly expressed in multinucleate giant cells,macrophages and epithelioid cells in granuloma and around the necrosis areas in patients with active tuberculosis lymphadenitis,while they were weakly expressed in patients with obsolete tuberculosis lymphadenitis and chronic nonspecific lymphadenitis.The levels of TGF-β1,TNF-α and MMP-9 in active tuberculosis lymphadenitis were significantly higher than those in obsolete tuberculosis lymphadenitis group,chronic nonspecific lymphadenitis group,and sarcoidosis group(all P<0.05).The ratio of TGF-β1/TNF-α in patients with active tuberculous lymphadenitis was significantly higher than that in patients with obsolete tuberculosis lymphadenitis(P<0.01).Conclusion: TGF-β1 and MMP-9 may be associated with the pathogenesis of tuberculous lymphadenitis.The ratio of TGF-β1 /TNF-α might be useful for predicting the progress of tuberculous lymphadenitis.