糖皮质激素受体在血管瘤和血管畸形中的表达及意义

目的：检测血管瘤和血管畸形组织中是否存在糖皮质激素受体，并探讨其在血管瘤和血管畸形中的意义。方法：手术切除25例血管瘤、18例血管畸形标本及12例正常皮下组织标本，用免疫组织化学方法检测其组织中糖皮质激素受体、血管内皮生长因子、Ki-67的表达，做图像分析测定，并对3项指标作相关性分析。结果：在血管瘤增生期，皮质激素受体、血管内皮生长因子、Ki-67均有较高表达；在血管瘤退化期、血管畸形和正常皮肤中，糖皮质激素受体、血管内皮生长因子、Ki-67表达极弱或无表达。并且糖皮质激素受体与血管内皮生长因子、Ki-67在血管瘤中的表达呈正相关。结论：糖皮质激素受体、血管内皮生长因子可能在血管瘤的病理发生过程发挥作用，外源性糖皮质激素与糖皮质激素受体结合，可能使血管内皮生长因子分泌减少，而促进血管瘤消退。而糖皮质激素受体、血管内皮生长因子在血管畸形的发生中则无明显作用。

Glucocorticoid receptor in hemangioma and vascular malformation

Objective To measure the level and evaluate the effect of glucocorticoid receptor(GR) and vascular endothelial growth factor(VEGF) in hemangioma and vascular malformation in children. Methods The surgical specimens were divided into 3 groups;1) proliferating hemangioma ( n =14),2)involuting hemangioma( n =11),and group 3) vascular malformation( n =18). The specimens of normal subcutaneous tissue were also collected ( n =12). GR,VEGF and Ki-67 were studied immunohistochemically.Results High expressions of GR,VEGF,and Ki-67 were present in proliferating hemangioma. Involuting hemangioma,vascular malformationand normal subcutaneous tissue revealed very weak or no expression of GR,VEGF and Ki-67. The expression of GR and VEGF showed positive linear correlation with hemangiomas.Conclusions GR and VEGF may play an important role in the growth and development of hemangioma. The glucocorticoid receptor may down-regulate VEGF in hemangiomas. There is no obvious role for GR and VEGF in the pathogenesis of vascular malformation.