| 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。 |
| 关键词: 淋巴管 肾移植 病理学 淋巴管密度 podoplanin |
| DOI：10.3724/SP.J.1008.2008.00418 |
| 投稿时间：2007-06-08修订日期：2008-01-18 |
| 基金项目:福建省自然科学基金（2006J0117）. |
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| Pathologic characteristics of lymphangiogenesis in renal transplants and its clinical implication |
| WU Wei-zhen1,CHEN Zhong-hua1,ZHU Ling-feng2,WANG Dong2,YE Yong-feng2,TAN Jian-ming 2* |
| (1.Institute of Organ Transplantation,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China;2.Institute of Organ Transplantation,Fuzhou General Hospital,PLA Nanjing Military Area Command,Fuzhou 350025) |
| 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. |
| Key words: lymphatic vessels kidney transplantation pathology lymphatic vessel density podoplanin |
