破骨细胞分化因子及其相关因子在儿童中耳胆脂瘤骨质破坏中的作用

目的 探讨破骨细胞分化因子(RANKL)和其配体核因子-κB受体活化因子(RANK)及假性受体骨保护素(OPG)即RANK-RANKL-OPG系统在儿童和成人中耳胆脂瘤骨质破坏中的作用.方法 选择4～14岁的中耳胆脂瘤患儿20耳(儿童组),以及18～60岁的中耳胆脂瘤患者20耳(成人组),应用免疫组织化学观察RANKL和OPG在儿童和成人胆脂瘤组织中的表达,对染色结果进行量化处理,并利用SPSS 11.0进行统计学分析.结果 1.RANKL阳性表达细胞数在儿童组和成人组中分别为(91.16±11.51)个、(80.33±12.72)个,二组比较差异有统计学意义(P=0.012);OPG阳性表达细胞数在儿童组和成人组中分别为(5.21±4.91)个、(5.66±3.76)个,二组比较差异无统计学意义(P=0.065);2.RANKL/OPG的比值在儿童组和成人组中分别为23.35±7.32、16.10±6.35,二组比较差异有统计学意义(P=0.009).3.胆脂瘤细胞的骨质破坏度和RANKL/OPG的比值呈正相关(rs=0.613 0,P<0.05).结论 RANKL可激活破骨细胞,在中耳胆脂瘤骨质破坏的机制中起重要作用;RANKL和OPG的比值在中耳胆脂瘤骨质破坏中是一个可靠的指标.

Effect of Ligand Nuclear Factor-KappaB and Its Correlated Factors in Bone Destruction in Middle Ear Cholesteatoma in Children

Objective To investigate effect of nuclear factor-kappaB ligand(RANKL),receptor activator of nuclear factor-kappaB(RANK) and osteoprotegerin(OPG) in bone destruction in middle ear cholesteatoma in children and adults.Methods An immunohistochemical analysis was carried out in 20 adult cholesteatoma tissues(adult group) and 20 children cholesteatoma tissues(children group) obtained during middle ear surgery,to examine the expressions of RANKL and OPG.The staining results were counted semiquantitatively.The data were analyzed statistically by using SPSS 11.0 software.Results 1.The number of RNAKL positive cells in children group and adult group were 91.16±11.51 and 80.33±12.72,respectively,and the contrast between them was statistically significant(P=0.012).The number of OPG positive cells in children group and adult group were 5.21±4.91 and 5.66±3.76,respectively,and the contrast between them was not statistically significant(P=0.065).2.The rate of RANKL and OPG in children group and adult group were 23.35±7.32 and 16.10±6.35,respectively,and the contrast between them was statistically significant(P=0.009).3.Bone destruction degree of cholesteatoma revealed positive correlation with the rate of RANKL and OPG(rs=0.613 0,P<0.05).Conclusions RANKL,an osteoclast activator,plays a key role in bone destruction in middle ear cholesteatoma.An increased RANKL/OPG expression ratio plays an important role in osteoclast activation.