骨纖維結(jié)構(gòu)不良病變組織雌激素受體和增殖細(xì)胞核抗原檢測(cè)及臨床意

作者：牛彥輝，王臻，鄭修存，吳作棟，沈強(qiáng)，張立明
【關(guān)鍵詞】 ,,纖維發(fā)育不良
Detection and significance of estrogen receptor and proliferating cell nuclear antigen in tissues of fibrous dysplasia of bone
　　【Abstract】 AIM: To investigate the relation between the clinical biological behavior and the expression of estrogen receptor (ER) and proliferating cell nuclear antigen (PCNA) in the tissues of fibrous dysplasia of bone (FDB). METHODS: Ninetyeight cases wrer surgically treated, pathologically confirmed as having fibrous dysplasia and followed up. The primary operation specimens were randomly selected and divided into recurrence group (n=24) and cured group (n=24), children group (n=26) and adult group(n=22). The ER and PCNA in the specimens were detected with monoclonal antibody to ER or PCNA by immunohistochemistry. RESULTS: The general positive expression rate of ER was 56.25%(27/48). The positivity rate in recurrence group was higher than that in cured group (70.83% vs 41.67%, P＜0.05) and the positivity rate in children group was higher than that in adult group (69.23% vs 40.91%, P＜0.05). The expression of PCNA in recurrence group was higher than that in cured group (P＜0.01). The expression of PCNA had a tendency to be higher in children group than that in adult group, but with no statistical significance (P＞0.05). CONCLUSION: FDB is relative to the estrogen. The abnormal expression of ER, the disturbance of the regulation of estrogen in bone development and metabolism may be the causes of the onset and recurrence of FDB. The expression of PCNA is related with the recurrence of FDB. PCNA can be used as a reference marker for prognosis of FDB.
　　【Keywords】 fibrous dysplasia of bone; receptors estrogen; proliferating cell nuclear antigen(PCNA); immunohistochemistry
　　【摘要】 目的： 探討骨纖維結(jié)構(gòu)不良（FDB）病變組織雌激素受體（ER）和增殖細(xì)胞核抗原（PCNA）的表達(dá)并討論其臨床意義. 方法： 98例FDB患者手術(shù)治療、病理確診并獲隨訪. 收集初次手術(shù)切除的標(biāo)本，隨機(jī)從治愈和復(fù)發(fā)病例中各抽取24例. 對(duì)復(fù)發(fā)組（n=24）與治愈組（n=24）、小兒組（n=26）與成人組（n=22）進(jìn)行對(duì)比，用單克隆抗體免疫組織化學(xué)方法對(duì)病變組織進(jìn)行ER和PCNA檢測(cè). 結(jié)果： ER總陽性率為56.25%(27/48). 復(fù)發(fā)組70.83%（17/24）明顯高于治愈組41.67%(10/24) （P＜0.05）. 小兒組69.23%(18/26)明顯高于成人組40.91%(9/22， P＜0.05). 復(fù)發(fā)組PCNA陽性表達(dá)強(qiáng)度顯著高于治愈組(P＜0.01)，而小兒組PCNA陽性表達(dá)高于成人組，但無統(tǒng)計(jì)學(xué)差異(P＞0.05). 結(jié)論： FDB的雌激素相關(guān)性表現(xiàn)為ER異常表達(dá)而導(dǎo)致骨發(fā)育及代謝調(diào)節(jié)紊亂；PCNA陽性表達(dá)強(qiáng)度與骨纖維結(jié)構(gòu)不良的復(fù)發(fā)密切相關(guān)，可作為其預(yù)后估測(cè)的參考指標(biāo).
　　【關(guān)鍵詞】 纖維發(fā)育不良，骨；受體，雌激素；增殖細(xì)胞核抗原；免疫組織化學(xué)
　　0引言
　　骨纖維結(jié)構(gòu)不良（fibrous dysplasia of bone, FDB）的發(fā)病率居骨與關(guān)節(jié)瘤樣病變的首位［1］，其臨床表現(xiàn)為，術(shù)后復(fù)發(fā)率高，兒童期更具高度復(fù)發(fā)傾向和侵襲性，部分病灶呈進(jìn)展性，部分病灶卻長期靜止，有些病例反復(fù)多次復(fù)發(fā)，少數(shù)可發(fā)生惡變，但泛發(fā)性骨纖維結(jié)構(gòu)不良（Albright綜合征）主要見于女性. 我們檢測(cè)骨纖病變組織中雌激素受（estrogen receptor, ER）和增殖細(xì)胞核抗原（proliferating cell nuclear antigen, PCNA）的變化并討論其臨床意義.
　　1材料和方法
　　1.1材料
　　標(biāo)本來源于197701/199806西京醫(yī)院骨科手術(shù)治療的骨纖患者病變組織石蠟埋塊. 選取其中有隨訪結(jié)果的98例患者初次手術(shù)標(biāo)本，根據(jù)隨訪結(jié)果分成復(fù)發(fā)與治愈兩組. 采用隨機(jī)數(shù)字法各選取24個(gè)標(biāo)本，共48例. 再根據(jù)患者年齡分為：小兒組（≤14歲）26例，成人組（≥15歲）22例. 一抗分別選用法國Immunotech公司產(chǎn)的鼠抗人ER mAb（1∶50）和丹麥DAKO公司產(chǎn)的鼠抗人PCNA mAb(1∶40). 二抗均選用Sigma公司產(chǎn)的生物素標(biāo)記羊抗鼠IgG. SABC試劑盒(武漢博士德生物工程有限公司).
　　1.2方法
　　標(biāo)本連續(xù)切片3張，1張HE染色，病理醫(yī)師再次確診，2張分

【骨纖維結(jié)構(gòu)不良病變組織雌激素受體和增殖細(xì)胞核抗原檢測(cè)及臨床意】相關(guān)文章：

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