Department of Neurosurgery, Kyoto University, Graduate School of Medicine, Kyoto, Japan.
World Neurosurg. 2010 Feb;73(2):100-7. doi: 10.1016/j.surneu.2009.07.008. Epub 2009 Oct 13.
Regrowth of cerebral AVMs after angiographically documented obliteration has been observed in children. In addition, AVMs in adults are reported to be at risk of regrowth despite an angiogram confirming complete removal. However, the mechanism by which regrowth occurs has not been clarified; neither is it clear when regrowth occurs after removal.
We report 3 cases showing regrowth of AVMs on postoperative angiogram performed 3 months after surgery. We also analyzed the protein levels of various factors that may influence AVM regrowth. Using immunohistochemistry, we analyzed the protein levels of the following factors: CD31 (PECAM), CD34, and CD105 (endoglin), which are endothelial or endothelial progenitor markers; VEGF, a growth factor that may influence AVM regrowth; and PCNA, a marker of proliferating cells. In addition, we analyzed the level of pERK.
We report 3 cases of early regrowth of cerebral AVMs. In recurrent AVM samples obtained at second operations, increased levels of perivascular CD105 and pERK immunoreactivity were seen.
在儿童中，已经观察到血管造影证实闭塞后大脑动静脉畸形（AVM）的再生长。此外，尽管血管造影证实完全切除，但报告称成年人的 AVM 有再生长的风险。然而，再生长发生的机制尚未阐明；也不清楚切除后何时会再生长。
我们报告了 3 例术后 3 个月行血管造影显示 AVM 再生长的病例。我们还分析了可能影响 AVM 再生长的各种因素的蛋白水平。我们使用免疫组织化学分析了以下因素的蛋白水平：CD31（PECAM）、CD34 和 CD105（内皮糖蛋白），这些是内皮或内皮祖细胞标志物；VEGF，一种可能影响 AVM 再生长的生长因子；以及 PCNA，增殖细胞的标志物。此外，我们分析了 pERK 的水平。
我们报告了 3 例大脑 AVM 的早期再生长病例。在第二次手术获得的复发性 AVM 样本中，可见血管周围 CD105 和 pERK 免疫反应性增加。
