移植肾内新生淋巴管的病理学特征及其临床意义
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福建省自然科学基金(2006J0117).


Pathologic characteristics of lymphangiogenesis in renal transplants and its clinical implication
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Supported by Natural Science Foundation of Fujian Province(2006J0117).

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    摘要:

    目的:探讨移植肾内新生微淋巴管的病理学特征,并分析其临床病理学意义。方法: 对45例肾移植患者移植肾组织标本,采用podoplanin单抗二步法免疫组化标记移植肾内微淋巴管,观察微淋巴管形态学及分布特点,并计算淋巴管密度(lymphatic vessel density,LVD),根据不同病理学诊断进行比较分析,并与正常肾组织作对照。结果:功能稳定的移植肾组织中微淋巴管数量较少,形态上与正常肾组织相同;急性排斥的移植肾内微淋巴管数量相对较多,管腔大小不等,多分布在末梢小动脉周围;慢性/硬化性移植肾的微淋巴管数明显增多,管腔扩张,扭曲,其周围多见局灶性单核细胞浸润。肾功能稳定的移植肾组织LVD平均值最低(1.26±0.27),与急性排斥和慢性/硬化性移植肾组织的比较均有统计学差异(P<0.05);慢性/硬化性移植肾组织LVD平均值最高(20.76±5.30),高于其他各组(P<0.01);肾功能稳定的移植肾组织与正常肾组织比较无差异。结论:移植肾内存在淋巴管增生的现象,并与排斥反应有关,在不同类型的排斥中淋巴管增生有不同的病理特点。

    Abstract:

    Objective:To investigate the pathologic characteristics of lymphangiogenesis in renal transplants and to analyze its clinical implication.Methods: The morphology and distribution of lymphangiogenesis were investigated by a biotin-streptavidin horseradish-peroxidase method with anti-podoplanin monoclonal antibody in 45 archival biopsies.The lymphatic vessel density (LVD) was calculated and the results were compared between different pathologic types and with the normal renal tissues.Results: Fewer podoplanin-positive lymphatic vessels were identified in the biopsies from the renal transplants with normal function,and the transplants had a similar morphological profile as normal renal tissues.More podoplanin-positive lymphatic vessels were observed in the transplants suffering acute rejection episode; the vessels mainly located around peripheral arteriole with different lumen sizes.Transplants with chronic rejection had the most podoplanin-positive lymphatic vessels with focal mononuclear infiltration and distended/distorted lymphatic vessels.The lowest mean LVD (1.26±0.27) was observed in the biopsies from transplants with normal function,which was significantly different from those in the acute rejection and chronic rejection groups (P<0.05).The highest mean LVD was found in the chronic rejection group (20.76±5.30),which was significantly higher than those of the other 2 groups (P<0.01); no significant difference was observed between the transplants with normal function and the normal kidney.Conclusion: Lymphatic neoangiogenesis occurs in the renal transplant and its pathologic characteristics differs in the transplants with different rejection types.

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  • 收稿日期:2007-06-08
  • 最后修改日期:2008-01-18
  • 录用日期:2008-04-10
  • 在线发布日期: 2008-04-16
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