Liapatas S, Nakou M, Rontogianni D
Dental School, Athens University, and Pathology Department, 'Evangelismos' General Hospital, Athens, Greece.
Int Endod J. 2003 Jul;36(7):464-71. doi: 10.1046/j.1365-2591.2003.00627.x.
To determine the cellular profile of human chronic periradicular lesions using immunohistochemical methods in order to study the differences in the cell infiltrate of periradicular granulomas and cysts.
The study population consisted of 45 individuals without any systemic disease. Biopsies were obtained during periradicular surgery. Paraffin-embedded sections were stained by the avidin-biotin complex method (ABC), whilst cryostat tissue sections were stained using the alkaline phosphatase antialkaline phosphatase assay (APAAP). These methods are highly valid and sensitive using a panel of specific monoclonal antibodies: CD4, CD8, CD3, CD10, HLADR, CD20, CD45RO, CD68 and CD57. The 45 specimens were characterized by the use of both techniques.
The 45 specimens were histologically diagnosed as: 25 periradicular granulomas, 17 periradicular cysts and 3 scar tissues. No statistically significant differences were detected in the inflammatory infiltrate between periradicular granulomas and cysts. Observation of the sections showed that the majority of inflammatory cells consisted of T and B lymphocytes and macrophages. T and B lymphocytes were equally distributed in 60% of the cases. The T4/T8 ratio ranged approximately from 1 to 3 and greater, being consistent with inflammation of periradicular tissues. The final differentiation of B lymphocytes to plasma cells was also detected, whilst natural killer (NK) cells were found in only 10 cases (22%). Moreover, antigen presenting cells and T suppressor/cytotoxic cells were found to be associated with both pre-existing and newly formed epithelium.
Periradicular granulomas and cysts represent two different stages in the development of chronic periradicular pathosis as a normal result of the process of immune reactions that cannot be inhibited.
采用免疫组织化学方法确定人类慢性根尖周病变的细胞特征，以研究根尖周肉芽肿和囊肿中细胞浸润的差异。
研究对象为45名无任何系统性疾病的个体。在根尖周手术期间获取活检组织。石蜡包埋切片采用抗生物素蛋白-生物素复合物法（ABC法）染色，而低温恒温器组织切片采用碱性磷酸酶抗碱性磷酸酶检测法（APAAP法）染色。使用一组特异性单克隆抗体：CD4、CD8、CD3、CD10、人类白细胞抗原DR（HLADR）、CD20、CD45RO、CD68和CD57，这些方法具有高度有效性和敏感性。通过这两种技术对45个标本进行特征分析。
45个标本经组织学诊断为：25个根尖周肉芽肿、17个根尖周囊肿和3个瘢痕组织。根尖周肉芽肿和囊肿之间的炎症浸润未检测到统计学上的显著差异。切片观察显示，大多数炎症细胞由T淋巴细胞、B淋巴细胞和巨噬细胞组成。在60%的病例中，T淋巴细胞和B淋巴细胞分布均匀。T4/T8比值约为1至3或更高，与根尖周组织炎症一致。还检测到B淋巴细胞最终分化为浆细胞，而自然杀伤（NK）细胞仅在10例（22%）中发现。此外，抗原呈递细胞和T抑制/细胞毒性细胞与既存上皮和新形成上皮均有关联。
根尖周肉芽肿和囊肿代表慢性根尖周病变发展过程中的两个不同阶段，是免疫反应过程的正常结果，无法被抑制。
