Lin Haotian, Luo Lixia, Ling Shiqi, Chen Wan, Liu Zhaochuan, Zhong Xiaojian, Wu Changrui, Chen Weirong, Liu Yizhi
State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.
Mol Vis. 2013;19:166-73. Epub 2013 Jan 28.
To investigate whether lymphatic microvessel density (LMVD) could be used as a predictive marker for the recurrence time of pterygia.
This was a prospective case series study. Ninety-six patients with unilateral eye primary nasal pterygia were included. The patients were clinically evaluated to grade the severity of their pterygia (32 were Grade 1, 29 were Grade 2, and 35 were Grade 3) before they underwent bare sclera resection with the use of mitomycin C. Excised tissues from the 96 patients and the ten normal nasal conjunctiva obtained from age-matched donor eyeballs (controls) were immunostained with LYVE-1 and CD31 monoclonal antibodies to evaluate LMVD and blood microvessel density (BMVD). The patients were followed up for three years or until pterygium recurrence was identified, which was defined as fibrovascular regrowth past the limbus in a previously compromised area. The recurrence time (RT) for a pterygium was calculated, and its relationship with LMVD and/or BMVD was statistically analyzed.
In total, there were 24 cases of pterygium recurrence. The recurrence rate of Grade 1 was 28.1% (9/32), Grade 2 was 24.1% (7/29), and Grade 3 was 22.9% (8/35), as classified in the primary pterygium (p>0.05); the overall recurrence rate was 25% (24/96) for all patients during the three-year follow-up. In the tissue analysis, there were a small number of CD31 (+), LYVE-1(-) BMVD and only a few CD31 (weak), LYVE-1(+) LMVD in the ten normal nasal conjunctiva tissues. BMVD and LMVD increased significantly in the pterygium tissue compared to the control tissue and were significantly correlated with the width and area of pterygium in Grades 1-3 (all p values <0.05). RT was not correlated with BMVD or pterygium grade, but LMVD was significantly and negatively correlated with RT within each group and in the total patient cohort. Furthermore, we determined that an LMVD greater than 20 in the surgical specimens predicted pterygium recurrence.
The LMVD of surgical specimens is an independent risk factor and a valuable predictive factor for the recurrence time of pterygia.
探讨淋巴管微血管密度（LMVD）是否可作为翼状胬肉复发时间的预测指标。
这是一项前瞻性病例系列研究。纳入96例单侧眼原发性鼻侧翼状胬肉患者。在患者接受丝裂霉素C辅助的单纯巩膜切除术之前，对其进行临床评估以分级翼状胬肉的严重程度（1级32例，2级29例，3级35例）。用LYVE-1和CD31单克隆抗体对96例患者切除的组织以及从年龄匹配的供体眼球获得的10例正常鼻结膜组织（对照）进行免疫染色，以评估LMVD和血微血管密度（BMVD）。对患者进行三年随访或直至确定翼状胬肉复发，复发定义为先前受损区域出现越过角膜缘的纤维血管再生。计算翼状胬肉的复发时间（RT），并对其与LMVD和/或BMVD的关系进行统计学分析。
总共24例翼状胬肉复发。按照原发性翼状胬肉分级，1级复发率为28.1%（9/32），2级为24.1%（7/29），3级为22.9%（8/35）（p>0.05）；在三年随访期间，所有患者的总体复发率为25%（24/96）。在组织分析中，10例正常鼻结膜组织中有少量CD31(+)、LYVE-1(-)的BMVD，仅有少数CD31（弱阳性）、LYVE-1(+)的LMVD。与对照组织相比，翼状胬肉组织中的BMVD和LMVD显著增加，并且在1 - 3级中与翼状胬肉的宽度和面积显著相关（所有p值<0.05）。RT与BMVD或翼状胬肉分级无关，但在每组以及全部患者队列中，LMVD与RT显著负相关。此外，我们确定手术标本中LMVD大于20可预测翼状胬肉复发。
手术标本的LMVD是翼状胬肉复发时间的独立危险因素和有价值的预测因素。
