摘要目的 评估源自骨髓的干细胞与翼状胬肉发病的相关性,探寻翼状胬肉的发病机制.方法 选择翼状胬肉头部达到瞳孔缘的病例12例(12眼),其中男6例,女6例;年龄51～66岁;原发性翼状胬肉8例,复发性翼状胬肉4例,均长于鼻侧.对照组材料来自同一眼球、距翼状胬肉边缘约10mm的正常球结膜组织.采用EnVision免疫组织化学法检测骨髓干细胞标志物来源的CD_(34)、AC133、STRO 1、C KIT的表达.结果 光镜下可见翼状胬肉组织中有大量带有骨髓干细胞或祖细胞阳性标志物来源的细胞,翼状胬肉组织头部阳性表达更强.4种阳性细胞的分布及细胞形态类似.C KIT阳性表达细胞聚集于翼状胬肉上皮基底组织和基质组织.上皮基底部阳性细胞呈圆形或椭圆形,而在基质组织中呈纺锤形且主要分布于血管周围.CD_(34)阳性表达细胞主要分布于翼状胬肉组织上皮基底层,在血管内皮也有阳性表达,类似于C KIT,但比C KIT上皮层组织阳性细胞少.细胞形态在上皮基底部呈圆形或椭圆形.AC133阳性表达细胞主要分布于上皮层,基质和血管内皮中也有阳性表达,形态类似CD_(34)和C KIT.STRO 1阳性表达细胞的分布不同,主要见于基质层,阳性细胞形态呈纺锤形,而上皮层中未见表达.各种因子的表达在原发性和复发性翼状胬肉间无明显差别.对照组切片中标志物的表达均呈阴性.结论 带有源自骨髓干细胞阳性标志物的细胞在翼状胬肉的发病和术后复发过程中可能起重要作用.

abstractsBackground Many researches have reported the high proliferation ability of pterygium tissue.However,the origin of cells in pterygium tissue and their role in pathogenesis and recurrence of pterygium are below understand up to now.Objective This study is to explore the role of bone marrow derived stem cells and progenitor cells in the pathogenesis of pterygium.Methods Informed consent was obtained from 12 patients with the pterygium stretching the edge of the pupil prior to this trail.Pterygium specimen was obtained from 8 patients with primary pterygium and 4 patients with recurrent pterygium during the operation.The normal conjunctival tissue was obtained from the location of 10 mm from the pterygium in the operation eye.The expression levels of marker of the primitive haematopoietic progenitors(AC133),marker of the haematopoietic progenitor cells and endothelium (CD_(34)),marker of haematopoietic and stromal progenitor cells (C KIT ),and differentiation antigen of bone marrow fibroblast cells and nonhaematopoietic progenitor cells 1 (STRO 1) were detected by using immunohistochemistry.Results Various progenitor cell markers originated from bone marrow,including CD_(34),AC133,C KIT,STRO 1,were positively expressed in pterygium specimen rather than normal conjunctival specimen mainly in the basal epithelium or stroma of pterygia tissue.Majority of the positive cells were seen in the head of pterygium.C KIT positive cells were observed mainly in the basal epithelium and stroma of pterygium.The morphology of positive cells varied upon different distribution.Fibroblast like and spindle shaped positive cells were seen in the stroma layer of pterygium,and round or ovoid shaped cells were in basal epithelial layer.The distribution and shape of positive cells for AC133 and CD_(34) were similar to ones of C KIT but numbers of cells were varied between them.C KIT,AC133 and CD_(34) positive cells were coexpressed in basal epithelium and vascular endothelium.Expression of STRO 1 was found in the stroma layer not in the basal epithelium of pterygium.Similar distribution,numbers and shape of positive cells were seen between recurrent and primary pterygium.Conclusion The cells with stem cells markers and progenitor cells markers originated from bone marrow may play a role in the pathogenesis of pterygium.