Cayé-Thomasen Per, Larsen Knud, Tingsgaard Peter, Tos Mirko
Department of Oto-rhino-laryngology, Head and Neck Surgery, Gentofte University Hospital of Copenhagen, Copenhagen, Denmark.
Acta Otolaryngol. 2004 Aug;124(6):706-11. doi: 10.1080/00016480310002096.
The expression of some growth factors in nasal polyps has been examined, although investigations addressing the reason for recurrence in some patients are lacking. Vascular endothelial growth factor (VEGF) is expressed by inflammatory cells, as well as by endothelial and epithelial cells of nasal polyps. To determine whether VEGF may play a role in the recurrence of nasal polyps, we aimed to compare VEGF expression in recurrent versus non-recurrent polyps. In addition, expression in polyps from asthmatic patients was compared with that in polyps from non-asthmatics.
A total of 30 patients with newly diagnosed nasal polyposis were included. Polypectomy was performed at enrolment in the long-term follow-up study. Fifteen patients had only 1 polypectomy (non-recurrence group; median observation period 81 months) and 15 had a median of 6.4 polypectomies (multiple recurrence group; median observation period 108 months). Five of 10 patients with asthma belonged to the non-recurrence group and 5 to the recurrence group. The polyp obtained at the initial polypectomy was examined for expression of VEGF by immunohistochemistry, using a polyclonal antibody. A blinded semi-quantitation and comparison of the intensity of immunolabelling were performed in recurrent versus non-recurrent polyps, as well as in asthmatics versus non-asthmatics.
VEGF expression was seen as varying staining of the polyp surface and gland epithelium, as well as of the vessel endothelium and some stromal mono- and polymorphonuclear leukocytes. Semi-quantitation of the staining intensity showed no significant differences between recurrent and non-recurrent polyps, or between asthmatics and non-asthmatics.
Our findings indicate that the level of immunohistochemical expression of VEGF in recurrent and nonrecurrent nasal polyposis is equivalent. Thus, the level of VEGF expression cannot predict a subsequent recurrence. The expression of VEGF is not upregulated in patients with asthma. Further studies are needed to determine the role of VEGF in nasal polyposis, with special reference to different stages of polyp formation, vascularization and growth.
已对鼻息肉中一些生长因子的表达进行了研究，不过缺乏针对部分患者复发原因的调查。血管内皮生长因子（VEGF）由炎性细胞以及鼻息肉的内皮细胞和上皮细胞表达。为了确定VEGF是否可能在鼻息肉复发中起作用，我们旨在比较复发性息肉与非复发性息肉中VEGF的表达。此外，还比较了哮喘患者息肉中的表达与非哮喘患者息肉中的表达。
共纳入30例新诊断的鼻息肉患者。在长期随访研究入组时进行了息肉切除术。15例患者仅进行了1次息肉切除术（非复发组；中位观察期81个月），15例患者中位进行了6.4次息肉切除术（多次复发组；中位观察期108个月）。10例哮喘患者中有5例属于非复发组，5例属于复发组。使用多克隆抗体通过免疫组织化学检查初次息肉切除时获得的息肉中VEGF的表达。对复发性息肉与非复发性息肉以及哮喘患者与非哮喘患者的免疫标记强度进行了盲法半定量和比较。
VEGF表达表现为息肉表面、腺上皮、血管内皮以及一些基质单核和多形核白细胞的不同染色。染色强度的半定量显示，复发性息肉与非复发性息肉之间或哮喘患者与非哮喘患者之间无显著差异。
我们的研究结果表明，复发性和非复发性鼻息肉病中VEGF的免疫组化表达水平相当。因此，VEGF表达水平无法预测随后的复发。哮喘患者中VEGF的表达未上调。需要进一步研究以确定VEGF在鼻息肉病中的作用，特别是参考息肉形成、血管生成和生长的不同阶段。
