抽脂术可保持微血管网络的形态完整性：一项对照研究中的流式细胞术和共聚焦显微镜证据
Liposuction Preserves the Morphological Integrity of the Microvascular Network: Flow Cytometry and Confocal Microscopy Evidence in a Controlled Study.
作者信息
Bertheuil Nicolas, Chaput Benoit, Berger-Müller Sandra, Ménard Cédric, Mourcin Frédéric, Watier Eric, Grolleau Jean-Louis, Garrido Ignacio, Tarte Karin, Sensébé Luc, Varin Audrey
机构信息
Dr Bertheuil is a Staff Surgeon and Dr Waiter is a Professor, Department of Plastic, Reconstructive and Aesthetic Surgery, Hospital Sud, University of Rennes, Rennes, France. Dr Chaput is a Staff Surgeon, Department of Plastic, Reconstructive, and Aesthetic Surgery, Rangueil Hospital, Toulouse, France. Dr Berger-Müller has a Post-doctorate Position, Dr Sensébé is a Head Director of Team 2, and Dr Varin is a Staff Researcher, STROMALab Laboratory, Rangueil Hospital, Toulouse, France. Drs Ménard and Mourcin are Staff Researchers and Dr Tarte is a Professor and Head Director, SITI Laboratory, Rennes University Hospital, Rennes, France; and INSERM U917, University of Rennes, Rennes, France. Drs Grolleau and Garrido are Professors, Department of Plastic, Aesthetic, and Reconstructive Surgery, Toulouse University Hospital, Toulouse, France.
出版信息
Aesthet Surg J. 2016 May;36(5):609-18. doi: 10.1093/asj/sjv209. Epub 2015 Nov 3.
BACKGROUND
Liposuction is a very popular technique in plastic surgery that allows for the taking adipose tissue (AT) on large surfaces with little risk of morbidity. Although liposuction was previously shown to preserve large perforator vessels, little is known about the effects of liposuction on the microvasculature network.
OBJECTIVES
The aim of this study was to analyze the effect of liposuction on the preservation of microvessels at tissue and cellular levels by flow cytometry and confocal microscopy following abdominoplasty procedure.
METHODS
Percentage of endothelial cells in AT from liposuction and en bloc AT was determined by multicolor flow cytometry. Moreover, vessel density and adipocyte content were analyzed in situ in 3 different types of AT (en bloc, from liposuction, and residual AT after liposuction) by confocal microscopy.
RESULTS
Flow cytometric analysis showed that en bloc AT contained 30.6% ± 12.9% and AT from liposuction 21.6% ± 9.9% of endothelial cells (CD31(pos)/CD45(neg)/CD235a(neg)/CD11b(neg)) (P = .009). Moreover, analysis of paired AT from the same patients (n = 5) confirmed a lower percentage of endothelial cells in AT from liposuction compared to en bloc AT (17.7% ± 4.5% vs 21.9% ± 3.3%, P = .031). Likewise, confocal microscopy showed that en bloc AT contained 8.2% ± 6.3%, AT from liposuction only 1.6% ± 1.0% (P < .0001), and AT after liposuction 8.9% ± 4.1% (P = .111) of CD31(pos) vessels. Conversely, adipocyte content was 39.5% ± 14.5% in the en bloc AT, 45% ± 18.4% in AT from liposuction (P = .390), and 18.8 ± 14.8% in AT after liposuction (P = .011).
CONCLUSIONS
For the first time, we demonstrate that liposuction preserves the microvascular network. Indeed, a low percentage of endothelial cells was found in AT from liposuction and we confirm the persistence of microvessels in the tissue after liposuction.
背景
抽脂术是整形手术中一种非常流行的技术，它能够在大面积获取脂肪组织（AT），且发病风险较小。尽管先前研究表明抽脂术可保留大的穿支血管，但对于抽脂术对微血管网络的影响却知之甚少。
目的
本研究旨在通过腹部整形术后的流式细胞术和共聚焦显微镜检查，分析抽脂术在组织和细胞水平对微血管保存的影响。
方法
通过多色流式细胞术测定抽脂获得的AT和整块AT中内皮细胞的百分比。此外，利用共聚焦显微镜对3种不同类型的AT（整块AT、抽脂获得的AT和抽脂术后残留的AT）的血管密度和脂肪细胞含量进行原位分析。
结果
流式细胞术分析显示，整块AT中内皮细胞（CD31阳性/CD45阴性/CD235a阴性/CD11b阴性）占30.6%±12.9%，抽脂获得的AT中占21.6%±9.9%（P = 0.009）。此外，对同一患者（n = 5）的配对AT分析证实，抽脂获得的AT中内皮细胞百分比低于整块AT（17.7%±4.5%对21.9%±3.3%，P = 0.031）。同样，共聚焦显微镜显示，整块AT中CD31阳性血管占8.2%±6.3%，抽脂获得的AT中仅占1.6%±1.0%（P < 0.0001），抽脂术后的AT中占8.9%±4.1%（P = 0.111）。相反，整块AT中脂肪细胞含量为39.5%±14.5%，抽脂获得的AT中为45%±18.4%（P = 0.390），抽脂术后的AT中为18.8±14.8%（P = 0.011）。
结论
我们首次证明抽脂术能保留微血管网络。实际上，在抽脂获得的AT中发现内皮细胞百分比很低，并且我们证实抽脂术后组织中微血管依然存在。
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