PCNA\S-100在颈椎后纵韧带骨化块病灶中表达的临床意义探讨

目的探讨颈椎后纵韧带骨化(OPLL)块病灶生长特点及增殖细胞核抗原(PCNA)\S-100蛋白在颈椎后纵韧带骨化块病灶中表达的临床意义。方法通过颈椎前路减压术从22例颈椎后纵韧带骨化患者切取颈椎后纵韧带骨化块标本,其中3例是椎板成形术后再次出现颈髓压迫症而手术。年龄22~78岁,中位年龄48.2岁,其中男14例,女8例。对照组:取自25岁以下的5例不同新鲜尸体的颈椎后纵韧带标本5块,2组标本进行HE和PCNA,S-100免疫组化染色。结果所有OPLL病例标本都有S-100蛋白及PCNA阳性细胞高表达,对照组尸体标本无S-100及PCNA阳性细胞出现。结论颈椎后纵韧带骨化块病灶具有增殖活跃并向软骨化生、骨化的特性;颈椎后纵韧带骨化灶前方的增生的纤维软骨细胞区是椎板成形术后脊髓压迫症再发主要原因。

The clinical values of the expression of PCNA and S-100 in the ossified mass of the cervical posterior longitudinal ligament

Objective To investigate the clinical values of the expression of proliferating cell nuclear antigen(PCNA) and S-100 in the ossified mass of the cervical posterior longitudinal ligament.Methods The 22 pieces of ossified mass specimens of the cervical posterior longitudinal ligament were obtained from 22 patients with ossification of posterior longitudinal ligament(OPLL) by anterior decompression approach in the cervical spine.Of the 22 specimens,3 specimens were obtained from the patients after laminoplasty.As controls,5 specimens of the cervical posterior longitudinal ligament were obtained from 5 fresh corpses below 25 years old by anterior approach.All the specimens were stained with HE and immunohistochemically stained with the monoclone antibody against the PCNA and the monoclone antibody against the S-100 protein antigen. Results The PCNA and S-100 were overexpressed in the ossifing matrices and chondrocytes of adjacent cartilaginous areas of ossification of the posterior longitudinal ligament.There was no expression of PCNA and S-100 in the controlled specimens.Conclusion The ossified mass of the cervical posterior longitudinal ligament has a character of continuous proliferation and ossification.The proliferating fibrocartilaginous areas before the ossified mass is an important pathogenetic factor of cervical myelopthy recurrence after laminoplasty.