PGP9.5和CD68在致痛椎间盘MRI高信号区中的表达

目的 免疫组化观察PGP9.5和CD68在腰椎致痛椎间盘MRI高信号区中的表达.方法 对26例经椎间盘造影复制出致疼痛的椎间盘源性腰痛患者MRI的T2像HIZ区椎间盘组织和4例脊柱侧凸椎间盘组织进行PGP9.5和CD68免疫组化染色观察.结果 组织学观察显示.HIZ对应部位椎间盘组织表现为血管化肉芽组织和不同退变程度的髓核.HIZ区出现大量增生的软骨样细胞和血管内皮细胞.实验组均观察到PGP9.5免疫染色阳性细胞,对照组没有观察到PGP9.5免疫染色阳性细胞.在HIZ区表达大量的PGP9.5免疫阳性细胞.HIZ区PGP9.5免疫阳性细胞明显多于HIZ区周边纤维环组织和对照组.（P〈0.05）实验组均观察到不等数量的CD68免疫染色阳性细胞,主要是巨噬细胞.对照组没有观察到CD68免疫染色阳性细胞.在HIZ区表达一定量的CD68免疫阳性细胞.HIZ区CD68免疫阳性细胞明显多于HIZ区周边纤维环组织和对照组.（P〈0.05）.结论 腰痛患者腰椎间盘MRI的HIZ区中表达大最PGP9.5免疫阳性细胞和CD68免疫阳性细胞,表明HIZ作为致痛椎间盘的一个特异性影像标志物的炎症机制基础.

The express of PGP9.5 and CD68 Immunoreactive cells in the high intensity zone(HIZ)on MRI contained within the lumbar discs

Objectives To observe the immunohistochemistry for PGP9.5and CD68 in the high intensity zone （HIZ） on MRI contained within the lumbar painful discs. Methods 26 disc samples showing high intensity zone （HIZ） on MRI in lumbar intervertchral disc from patients with low hack pain and controls requiring surgery lbr scoliosis （n= 4） were harvested during surgery. Lumbar discography was used to reproduce concordant pain in 26 patients with low back pain in this study. Discs were immunostained using antibodies to PGP9.5 and CD68. Results The histologic study of the consecutive sagittal slices of the HIZ showed a lot of proliferated small round cells and fibroblasts, which was the evidence of the repairing the injured intervertebral disc after the disruption of annulus fibrosus as well. Blood proliferation and inflammaton cells infiltration were also seen. PGP9.5 immunostain positive ceils were tbund in the experimental group and not/bund in the control group. A lot of PGP9.5 immunostain positive cells were found in HIZ. The number of PGPg.5 immunostain positive cells was significantly higher in HIZ than that in the annulus fibrosus around HIZ and that of the control group （P〈0.05）. CD68 immunostain positive cells were found in the experimental group and not found in the control group. A lot of CD68 immunostain positive cells were found in HIZ. The number of PGPg.5 immunostain positive cells was significantly higher in HIZ than that in the annulus fibrosus around HIZ and that of the control group （P〈0.05）. Conclusions High PGP9.5 and CD68 expression in HIZ on MRI contained within the anulus of discs of patients with low back pain may indicated the inflammation mechanism for HIZ as specificity sign of painful disc on MRI.