Department of ENT, Cizre State Hospital, Sirnak, Turkey.
Am J Otolaryngol. 2013 Nov-Dec;34(6):652-7. doi: 10.1016/j.amjoto.2013.06.007. Epub 2013 Aug 5.
The aim of our study was to investigate the relationship between the destruction of temporal bone structures, ossicular chain destruction, dissemination of cholesteatoma and the expressions of bone morphogenetic proteins (BMPs), BMP-2, BMP-4 and BMP-6 in patients with acquired cholesteatoma.
This study was performed in a total of 80 patients with cholesteatoma and without cholesteatoma who had undergone surgery due to chronic otitis media. The patients were grouped as the study and the control groups. The study group comprised patients with primary acquired cholesteatoma, and the control group consisted of chronic otitis media patients without cholesteatoma. The samples were obtained from cholesteatoma tissue and the external acoustic meatus skin in study group patients and they were obtained from the external acoustic meatus skin only in control group patients. The Reverse Transcriptase Polymerase Chain Reaction method was used for the measurements of BMPs, BMP-2, BMP-4 and BMP-6 expressions. Polymerase Chain Reaction was studied by isolation of Ribonucleic Acid from the tissue samples.
When the expressions of BMP in the external acoustic meatus skin were compared between the study and the control groups, the BMPs, BMP-2 and BMP-6 were determined to have a statistically significant relation in the study group (p<0.05), but BMP-4 was not significant (p>0.05). When the expression of BMP in cholesteatoma tissue was investigated in the study group patients, the BMPs, BMP-2 and BMP-6 were determined with statistically significant positivity (p<0.05), but there was no significant positivity for BMP-4 (p>0.05). In the study group, there was no statistical significance between the expressions of BMPs, BMP-2, BMP-4 and BMP-6 in cholesteatoma tissue, in the external acoustic meatus skin, and temporal and ossicular chain destruction, and dissemination of cholesteatoma (p>0.05). A statistically significant positivity for BMPs expression in cholesteatoma tissue was determined in patients with destruction of the incus+malleus+stapes (p<0.05).
The expressions of BMPs, BMP-2 and BMP-6, were elevated in cholesteatoma tissue. Furthermore, the positivity of BMPs expression was statistically significant in patients with destruction of all the ossicles, and we think that this marker can be used for evaluation of the aggressiveness of cholesteatoma.
本研究旨在探讨获得性胆脂瘤患者中耳颞骨结构破坏、听骨链破坏、胆脂瘤扩散与骨形态发生蛋白(BMPs)、BMP-2、BMP-4 和 BMP-6 表达之间的关系。
本研究共纳入 80 例因慢性中耳炎行手术治疗的胆脂瘤患者和无胆脂瘤患者。将患者分为研究组和对照组。研究组为原发性获得性胆脂瘤患者,对照组为慢性中耳炎无胆脂瘤患者。研究组患者取自胆脂瘤组织和外耳道皮肤,对照组患者仅取自外耳道皮肤。采用逆转录聚合酶链反应(RT-PCR)法检测 BMPs、BMP-2、BMP-4 和 BMP-6 的表达。通过从组织样本中分离核糖核酸来研究聚合酶链反应。
当比较研究组和对照组外耳道皮肤中 BMP 的表达时,发现研究组的 BMPs、BMP-2 和 BMP-6 有统计学意义(p<0.05),但 BMP-4 无统计学意义(p>0.05)。当研究组患者的胆脂瘤组织中 BMP 的表达时,发现 BMPs、BMP-2 和 BMP-6 有统计学意义的阳性(p<0.05),但 BMP-4 无统计学意义的阳性(p>0.05)。在研究组中,胆脂瘤组织、外耳道皮肤、颞骨和听骨链破坏以及胆脂瘤扩散之间的 BMPs、BMP-2、BMP-4 和 BMP-6 表达无统计学意义(p>0.05)。在镫骨+砧骨+锤骨全部破坏的患者中,胆脂瘤组织中 BMPs 表达有统计学意义的阳性(p<0.05)。
BMPs、BMP-2 和 BMP-6 在胆脂瘤组织中表达升高。此外,所有听小骨均破坏的患者 BMPs 表达阳性具有统计学意义,我们认为该标志物可用于评估胆脂瘤的侵袭性。