Storer Kingsley P, Tu Jian, Karunanayaka Athula, Morgan Michael K, Stoodley Marcus A
Prince of Wales Medical Research Institute, University of New South Wales, Sydney, New South Wales, Australia.
J Clin Neurosci. 2007 Oct;14(10):975-80. doi: 10.1016/j.jocn.2006.12.005. Epub 2007 Jul 23.
Thrombosis is an important end-point in the obliteration of vascular malformations after radiosurgery. The aim of this study was to investigate the expression of thrombotic molecules in arteriovenous malformations (AVMs) and cavernous malformations (CMs), and in AVMs after radiosurgery. Fresh-frozen surgical specimens from 18 AVMs (including three that had previously been treated with radiosurgery), seven CMs, and three control specimens were studied. The expression of tissue factor, thrombomodulin and von Willebrand factor (vWF) were examined using immunofluorescence. Thrombomodulin and vWF were expressed in the endothelium of all specimens, while tissue factor was predominately found in the perivascular region and vascular adventitia. Previous treatment of AVMs with either radiation or embolisation did not significantly alter the intensity of expression. In some irradiated lesions, vessels were found with absent endothelial vWF staining and exposed tissue factor. This study has demonstrated that loss of the endothelium and exposure of underlying tissue factor occurs in irradiated AVMs. There were no significant differences in the expression of these thrombotic molecules in vascular malformations when compared to control vessels. While no long-term alterations in antigen expression were observed after radiosurgery, further work may elucidate the nature of the immediate response to irradiation.
血栓形成是放射外科手术后血管畸形闭塞的一个重要终点。本研究的目的是调查动静脉畸形（AVM）和海绵状畸形（CM）以及放射外科手术后AVM中血栓形成分子的表达情况。研究了来自18例AVM（包括3例先前接受过放射外科治疗的病例）、7例CM和3例对照标本的新鲜冷冻手术标本。使用免疫荧光法检测组织因子、血栓调节蛋白和血管性血友病因子（vWF）的表达。血栓调节蛋白和vWF在所有标本的内皮中均有表达，而组织因子主要存在于血管周围区域和血管外膜。先前对AVM进行的放射治疗或栓塞治疗并未显著改变表达强度。在一些接受过照射的病变中，发现血管内皮vWF染色缺失且组织因子暴露。本研究表明，接受照射的AVM中存在内皮缺失和潜在组织因子暴露的情况。与对照血管相比，这些血栓形成分子在血管畸形中的表达没有显著差异。虽然放射外科手术后未观察到抗原表达的长期改变，但进一步的研究可能会阐明对照射的即时反应的性质。
