Tan K T, Wijeratne D, Shih B, Baildam A D, Bayat A
Plastic and Reconstructive Surgery Research, School of Translational Medicine, Manchester Interdisciplinary Biocentre, University of Manchester, Manchester, UK.
Eur Surg Res. 2010;45(3-4):327-32. doi: 10.1159/000321009. Epub 2010 Oct 30.
The pathogenesis of periprosthetic capsular contracture following breast implant surgery is unclear. The aim of this study was to identify the expression of tumour necrosis factor-α (TNF-α), collagen type III α(1) (COL3A1), transforming growth factor-β(1) (TGF-β(1)) and connective tissue growth factor (CTGF) in different Baker grades of breast capsular contracture.
Seven periprosthetic breast capsule specimens were collected from 6 patients. TNF-α, COL3A1, TGF-β(1) and CTGF gene expression were analysed using real-time quantitative polymerase chain reaction. Immunohistolocalisation of TNF-α was performed on paraffin-embedded sections. Significant correlations were analysed using the Pearson correlation coefficient.
TNF-α expression was associated with increased Baker grade of capsular contracture (Pearson correlation, r = 0.558; p = 0.02). COL3A1 gene expression was reduced with increasing severity of contracture (r = -0.490; p = 0.05). There were no significant correlations between TGF-β(1) and CTGF expression with Baker grade. Positive TNF-α staining in breast capsules was localised to fibroblasts, macrophages, and extracellularly close to the prosthesis.
The increased expression of TNF-α may play a key role in the inflammatory response associated with capsular contracture. The corresponding decrease in COL3A1 may contribute to the change in capsular physical properties seen in capsular contracture.
乳房植入术后假体周围包膜挛缩的发病机制尚不清楚。本研究的目的是确定不同贝克分级的乳房包膜挛缩中肿瘤坏死因子-α（TNF-α）、Ⅲ型胶原α1（COL3A1）、转化生长因子-β1（TGF-β1）和结缔组织生长因子（CTGF）的表达情况。
从6例患者中收集7个假体周围乳房包膜标本。采用实时定量聚合酶链反应分析TNF-α、COL3A1、TGF-β1和CTGF基因表达。对石蜡包埋切片进行TNF-α免疫组织定位。使用Pearson相关系数分析显著相关性。
TNF-α表达与包膜挛缩的贝克分级增加相关（Pearson相关性，r = 0.558；p = 0.02）。COL3A1基因表达随挛缩严重程度增加而降低（r = -0.490；p = 0.05）。TGF-β1和CTGF表达与贝克分级之间无显著相关性。乳房包膜中TNF-α阳性染色定位于成纤维细胞、巨噬细胞以及假体附近的细胞外。
TNF-α表达增加可能在与包膜挛缩相关的炎症反应中起关键作用。COL3A1相应减少可能导致包膜挛缩中所见的包膜物理性质变化。
