特发性脊柱侧凸青少年软骨内生长加速：一项初步组织形态计量学研究。
Accelerated endochondral growth in adolescents with idiopathic scoliosis: a preliminary histomorphometric study.
作者信息
Zheng Xin, Wang Weijun, Qian Bangping, Wang Shoufeng, Zhu Zezhang, Wang Bin, Sun Xu, Ding Yitao, Qiu Yong
机构信息
Department of Spine Surgery, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Zhongshan Road 321, Nanjing 210008, China.
出版信息
BMC Musculoskelet Disord. 2014 Dec 13;15:429. doi: 10.1186/1471-2474-15-429.
BACKGROUND
Abnormal longitudinal growth has been identified in the early pubertal stage of idiopathic scoliosis (IS) and is thought to contribute to the development of scoliosis. This phenotype may be caused by abnormal endochondral ossification, but histological evidence is lacking. The aim of this study was to investigate whether there is abnormal endochondral ossification in IS patients at early stage of puberty by histomorphometric analysis of their iliac cartilage.
METHODS
Fifty-two patients with IS and 19 controls were recruited and grouped according to their Risser grade (Group A: Risser grade 0 with Oxford stage 2-3; Group B: Risser grade 2). Group A consisted of 20 IS patients (mean age: 12.3 years) and 9 controls (mean age: 12.0 years), while Group B included 32 IS patients (mean age: 13.8 years) and 10 controls (mean age: 13.7 years). Biopsies of the iliac cartilage were harvested intra-operatively and prepared using routine histological methods. Histomorphometric analysis was performed to quantify the thickness of the hypertrophic zone, the area and number of chondrocytes in the cell-nest, and the number of chondrocytes in the proliferative zone using Image-Pro Plus software.
RESULTS
In Group A, a significantly thicker hypertrophic zone and larger cell-nest area and number of cells within the cell-nest, and in the proliferative zone, were found in iliac cartilages from IS patients compared with those of controls (all P < 0.05). In group B however, there were no significant differences in histomorphometric parameters between IS patients and the controls.
CONCLUSIONS
The differences in the histomorphometric results between IS patients and their controls for patients with Risser grade 0 and Oxford grades 2 & 3, but not in those with Risser grade 2, indicated a pattern of accelerated endochondral growth in IS at the early stage of puberty, but not at the late stage.
TRIAL REGISTRATION
Current Controlled Trials: ChiCTR-CCC-13003988. Registered 17 December 2013. http://www.chictr.org/usercenter/project/edit.aspx?proj=6233.
背景
特发性脊柱侧凸（IS）患者在青春期早期已被证实存在纵向生长异常，且认为这是脊柱侧凸发展的原因之一。这种表型可能是由软骨内成骨异常引起的，但缺乏组织学证据。本研究旨在通过对髂骨软骨进行组织形态计量学分析，调查青春期早期IS患者是否存在软骨内成骨异常。
方法
招募了52例IS患者和19例对照，并根据Risser分级进行分组（A组：Risser 0级且牛津分期为2 - 3期；B组：Risser 2级）。A组包括20例IS患者（平均年龄：12.3岁）和9例对照（平均年龄：12.0岁），而B组包括32例IS患者（平均年龄：13.8岁）和10例对照（平均年龄：13.7岁）。术中获取髂骨软骨活检组织，并采用常规组织学方法进行制备。使用Image-Pro Plus软件进行组织形态计量学分析，以量化肥大带的厚度、细胞巢中软骨细胞的面积和数量以及增殖带中软骨细胞的数量。
结果
在A组中，与对照组相比，IS患者髂骨软骨的肥大带明显更厚，细胞巢面积和细胞数量更大，增殖带中的情况也是如此（所有P < 0.05）。然而，在B组中，IS患者和对照组之间的组织形态计量学参数没有显著差异。
结论
Risser 0级且牛津分期为2和3期的IS患者与其对照组在组织形态计量学结果上存在差异，而Risser 2级患者则无差异，这表明IS在青春期早期存在软骨内生长加速的模式，但在晚期不存在。
试验注册
中国临床试验注册中心：ChiCTR - CCC - 13003988。于2013年12月17日注册。http://www.chictr.org/usercenter/project/edit.aspx?proj = 6233。
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