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目的 探讨凋亡在婴幼儿血管瘤增生退化机制中的作用 ,为临床治疗提供新的思路。方法 选取以往未经任何治疗的手术切除的血管瘤病理组织切片 ,根据病理组织学表现 ,参照Mul liken标准分为两组。第一组均为增生期血管瘤 ,共 10例 ,其中男 5例 ,女 5例 ,平均年龄 (4.7± 2 .4 )个月 (1～ 12个月 ) ;第二组均为退化期血管瘤 ,共 10例 ,其中男 4例 ,女 6例 ,平均年龄 (18.7± 11.7)个月 (7个月～ 5岁 )。采用末端脱氧核苷酸基转移酶介导的脱氧尿苷三磷酸 (dUTP)—生物素颈端标记法 (TUNEL方法 ) ,检测两组病理组织切片的凋亡阳性细胞数 ,计算凋亡指数 (AI) =染色阳性细胞数 (10个HPF中 ) /计数细胞总数 (10 0× 10 )× 10 0 % ,并采用Mann WhitneyU test方法进行统计学分析。结果 增生期血管瘤组凋亡指数为 2 .16± 0 .6 88,退化期血管瘤组凋亡指数为 2 3.7± 11.84 ,两者比较差异有显著性意义 (P <0 .0 1)。结论 血管瘤是小儿常见良性肿瘤 ,大多可自然消退 ,但仍有10 %左右病例可产生严重并发症危及患儿生命。目前血管瘤增生及自然消退的机制尚不明确 ,本文结果发现伴随血管瘤增生退化的自然病程 ,存在着逐渐活跃的细胞凋亡现象 ,提示凋亡在血管瘤增生退化机制中可能起着重要作用。
Objective To explore the role of apoptosis in the mechanism of hyperplasia and degeneration of infantile hemangiomas and to provide new ideas for clinical treatment. Methods Histopathological sections of the previously resected hemangiomas without any treatment were selected and divided into two groups according to the Muliken criteria according to the histopathological findings. The first group were all hyperplastic hemangiomas, with a total of 10 cases, including 5 males and 5 females, with an average age of (4.7 ± 2. 4) months (range, 1 to 12 months) A total of 10 patients, including 4 males and 6 females, average age (18.7 ± 11.7) months (7 months to 5 years). TUNEL method was used to detect the number of apoptotic cells in the pathological sections of the two groups, and the apoptosis index ( AI) = number of stained positive cells (10 HPF) / total number of cells counted (10 × 10) × 10 0%, and statistical analysis was performed by Mann WhitneyU test. Results The apoptotic index of proliferative hemangioma group was 2.16 ± 0.888, and the apoptotic index of degrading hemangioma group was 23.7 ± 11.84. There was significant difference between the two groups (P <0.01). Conclusion Hemangioma is a common benign tumor in children, most of which can be spontaneous regression, but still about 10% of cases may have serious complications endanger the lives of children. The current mechanism of hemangiomas hyperplasia and spontaneous regression is not clear, the results of this study found that accompanied with the natural course of hemangioma proliferation and degeneration, there is a gradual active apoptosis, suggesting that apoptosis may play an important role in the mechanism of hemangiomas proliferation and degeneration .