Shiromany Aseem, Sood Rahul, Akifuddin Syed, Sidhu Gagandeep Kaur, Khan Nadia, Singla Kapil
Reader, Department of Conservative & Endodontics, KD Dental College Mathura, (UP), India .
Professor and Head, Department of Oral and Maxillofacial Surgery, Maharaja Ganga Singh Dental College and Research Center , Sriganganagar, Rajasthan, India .
J Clin Diagn Res. 2014 Dec;8(12):ZC61-4. doi: 10.7860/JCDR/2014/11623.5340. Epub 2014 Dec 5.
The role of mast cells as the key effector of allergic inflammation, anaphylactic inflammatory reactions and in the pathogenesis of chronic inflammation, is well-known. The present study is adopted to compare mast cells and inflammatory cells within periapical granuloma and cysts and localize the mast cells and quantify their number in the periapical cysts so as to propose a role of mast cells in the pathogenesis of this lesion.
Biopsy specimens of 30 periapical lesions were stained with hematoxylin-eosin, and immunohistochemical Mast Cell Tryptase from Bio SB (IHC detection system kit) antibody. The tryptase positive mast cells and mononuclear inflammatory cells were counted in 10 consecutive high power fields (100X) using the binocular microscope from Motic attached to a computer with Motic Advanced Images 3.2 software.
Comparative microscopic analysis indicated that periapical cyst shows more percentage of mast cells and less percentage of inflammatory cell than periapical granuloma (comparison of mean and standard deviation of total number of mast cells and inflammatory cells, mast cells 3.15±1.39 in the granuloma group and 4.43±1.91in the cyst group, inflammatory cells, 67.11±1.2 in the granuloma group and 52.66±0.8 in the cyst group). Numerous degranulated mast cells were observed in the fibrous wall than the inflammatory infiltrate of the periapical cysts. The mean and standard deviation of degranulated mast cells between the inflammatory and fibrous zone within the cyst group, being 0.95±1.10 and1.68±1.34 respectively. The values varied significantly between the two zones.
The number of inflammatory cells in the cyst group is less than periapical granuloma and total number of mast cells in the cyst group is more as compared to periapical granuloma. The degranulated cells were quantified and they were higher in the fibrous area of the cysts than the inflammatory zone. This study could support the fact that the various mediators released on degranulation play a role in the connective tissue remodeling, chronicity and expansion of the periapical lesion.
肥大细胞作为变应性炎症、过敏反应性炎症反应及慢性炎症发病机制中的关键效应细胞，其作用已广为人知。本研究旨在比较根尖周肉芽肿和囊肿内的肥大细胞与炎症细胞，对根尖周囊肿内的肥大细胞进行定位并量化其数量，从而提出肥大细胞在该病变发病机制中的作用。
30例根尖周病变的活检标本用苏木精 - 伊红染色，并用来自Bio SB的免疫组化肥大细胞胰蛋白酶（免疫组化检测系统试剂盒）抗体染色。使用附有Motic Advanced Images 3.2软件的电脑的Motic双目显微镜，在10个连续的高倍视野（100X）中对胰蛋白酶阳性肥大细胞和单核炎症细胞进行计数。
显微镜对比分析表明，与根尖周肉芽肿相比，根尖周囊肿中肥大细胞的百分比更高，炎症细胞的百分比更低（肥大细胞和炎症细胞总数的均值及标准差比较，肉芽肿组肥大细胞为3.15±1.39，囊肿组为4.43±1.91；炎症细胞，肉芽肿组为67.11±1.2，囊肿组为52.66±0.8）。在根尖周囊肿的纤维壁中观察到的脱颗粒肥大细胞比炎症浸润中的更多。囊肿组炎症区和纤维区之间脱颗粒肥大细胞的均值及标准差分别为0.95±1.10和1.68±1.34。两个区域的值差异显著。
囊肿组中的炎症细胞数量少于根尖周肉芽肿，且囊肿组中的肥大细胞总数比根尖周肉芽肿更多。对脱颗粒细胞进行了量化，发现囊肿纤维区域中的脱颗粒细胞比炎症区域中的更高。本研究支持以下事实：脱颗粒时释放的各种介质在根尖周病变的结缔组织重塑、慢性化及扩大中起作用。
