Department of Pulmonary Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Respiration. 2019;98(1):60-69. doi: 10.1159/000496152. Epub 2019 Feb 20.
Granulation tissue is a common complication of airway stenting, but no published methods can quantify the volume and type of tissue that develops.
To use design-based stereology to quantify changes in tissue volume and type associated with airway stenting.
We compared drug-eluting stents (DES) filled with gendine to standard silicone stents in pigs in an assessor-blinded randomized trial. Tracheal stents were placed via rigid bronchoscopy. After 1 month, animals were euthanized and necropsies were performed. Antimicrobial effects of the DES were assessed in trachea tissue samples, on the DES surface, and with residual gel from the DES reservoir. Tracheal thickness was measured using orthogonal intercepts. Design-based stereology was used to quantify the volume density of tissues using a point-counting method. The volume of each tissue was normalized to cartilage volume, which is unaffected by stenting.
Pigs were randomized to DES (n = 36) or control stents (n = 9). The drug was successfully eluted from the DES, and the stent surface showed antibacterial activity. DES and controls did not differ in tissue microbiology, tracheal thickness, or granulation tissue volume. Compared to nonstented controls, stented airways demonstrated a 110% increase in soft-tissue volume (p = 0.005). Submucosal connective tissue (118%; p < 0.0001), epithelium (70%; p < 0.0001), submucosal glands (47%; p = 0.001), and smooth muscle (41%; p < 0.0001) increased in volume.
Stenting doubles the volume of soft tissue in the trachea. Design-based stereology can quantify the tissue changes associated with airway stenting.
肉芽组织是气道支架的常见并发症，但目前尚无发表的方法可以量化形成的组织体积和类型。
使用基于设计的体视学来量化与气道支架相关的组织体积和类型的变化。
我们在一项评估者盲法随机试验中比较了载药支架（DES）与标准硅胶支架在猪中的应用。通过硬质支气管镜放置气管支架。1 个月后，处死动物并进行尸检。评估了 DES 在气管组织样本、DES 表面和 DES 储液器中的残留凝胶上的抗菌作用。使用正交截距测量气管厚度。使用点计数法通过基于设计的体视学来量化组织的体积密度。将每种组织的体积归一化为软骨体积，软骨体积不受支架的影响。
猪被随机分配到 DES（n = 36）或对照支架（n = 9）组。DES 成功洗脱药物，支架表面显示出抗菌活性。DES 和对照组在组织微生物学、气管厚度或肉芽组织体积方面没有差异。与未支架的对照组相比，支架气道的软组织体积增加了 110%（p = 0.005）。黏膜下结缔组织（118%；p < 0.0001）、上皮（70%；p < 0.0001）、黏膜下腺体（47%；p = 0.001）和平滑肌（41%；p < 0.0001）体积增加。
支架使气管内的软组织体积增加了一倍。基于设计的体视学可以量化与气道支架相关的组织变化。
