增殖性视网膜病变玻璃体切割物的细胞学及免疫组化研究

目的探讨不同视网膜增殖性疾病细胞增殖的特征及其异同。方法采用３种特异性抗原，即抗人细胞角蛋白（ｃｙｔｏｋｅｒａｔｉｎ，ＣＫ），抗胶质纤维酸性蛋白（ｇｌｉａｌｆｉｂｒｉｌａｒｙａｃｉｄｉｃｐｒｏｔｅｉｎ，ＧＦＡＰ），抗肌动蛋白（Ａｃｔｉｎ）对２８例临床上不同的视网膜疾病的增殖膜及玻璃体切除液样本进行免疫细胞化学研究。结果增殖性玻璃体视网膜病变（ｐｒｏｌｉｆｅｒａｔｉｖｅｖｉｔｒｅｏｒｅｔｉｎｏｐａｔｈｙ，ＰＶＲ）的增殖特征以胶质细胞和视网膜色素上皮细胞（ｒｅｔｉｎａｌｐｉｇｍｅｎｔｅｐｉｔｈｅｌｉｕｍ，ＲＰＥ）为主，二者在ＰＶＲ发病中作用不同。增殖性糖尿病视网膜病变（ｐｒｏｌｉｆｅｒａｔｉｖｅｄｉａｂｅｔｉｃｒｅｔｉｎａｏｐａｔｈｙ，ＰＤＲ）玻璃体内出现ＲＰＥ细胞可加剧增殖膜收缩。增殖膜血管壁上肌动蛋白含量增多可能对周细胞脱落起促进作用。结论玻璃体内细胞增殖与生长因子水平升高可能是增殖性病变日益加剧的重要机制和原因之一。

Immunohistochemical study on vitrectomy specimens of proliferative retinal diseases

Objective To evaluate the characteristics of cellular proliferation in different retinal diseases. Methods Three specific antibodies [to cytokeratin (CK), glial fibrillary acidic protein (GFAP) and actin, respectively] were used. Vitrectomy specimens from 28 cases with different proliferative retinal diseases were studied immunohistochemically. Results In the vitreous with proliferative vetreoretinopathy (PVR), most of the proliferative cells were derived from glial and retinal pigment epithelial (RPE) cells. In the vitreous of proliferative diabetic retinopathy (PDR), RPE cells might enhance the contraction of proliferative membranes. Increase in actin in fibrovascular membranes with PDR may play a positive role on the pericytes dropping out from microvessels. Conclusion The cell proliferation in the vitreous associated with the increase of levels of growth factors in pathological vitreous, possibly, is one of the mechanisms for the deterioration of proliferative retinal diseases.