Butcovan Doina, Mocanu Veronica, Haliga Raluca Ecaterina, Ioan Beatrice Gabriela, Danciu Mihai, Tinica Grigore
Department of Cardiovascular Surgery, "Prof George Georgescu" Institute of Cardiovascular Diseases, Iasi 700503, Romania.
Department of Morpho-Functional Sciences-Pathology, 'Grigore T. Popa' University of Medicine and Pharmacy, Iasi 700115, Romania.
Exp Ther Med. 2019 Oct;18(4):3046-3052. doi: 10.3892/etm.2019.7903. Epub 2019 Aug 16.
The present study aimed to analyze the histological characteristics of surgical thoracic aortic aneurysm (TAA) and abdominal aortic aneurysm (AAA) specimens on the basis of the most recent consensus documents on non-inflammatory and inflammatory lesions. The current study also aimed to establish an association with various risk factors. Aortic wall specimens were collected from 52 patients (38 men and 14 women; age, 19-80 years) undergoing surgery for aortic dilatation at The Cardiovascular Disease Institute (Iasi, Romania). For histological evaluation, the aortic specimens (39 TAAs and 13 AAAs) were stained with hematoxylin-eosin, Van Giessen, alcian blue and Movat pentachrome. The specimens were evaluated and graded according to the severity of histopathological conditions: Fragmentation of elastic fibers, medial mucoid accumulation, smooth muscle cell loss and medial fibrosis. The severity of atherosclerotic lesions in surgically resected segments of the aorta were graded as follows: i) mild=1; ii) moderate=2; and iii) severe=3. The risk factors associated with TAA were the male sex (80%), smoking (56%), hypertension (33%) and bicuspid aortic valve (13%). Advanced age (70 years), male sex (69%) and smoking (54%) were determined to be the risk factors of AAA. The histopathological abnormalities included medial degeneration (MD) (82%), atherosclerosis (ATS) (42%) and aortitis (10%). MD was the leading histopathological diagnosis in TAA and the severity of lesions were graded as follows: Mild (8% of cases), moderate (44% of cases) and severe (31% of cases). Severe atherosclerotic lesions were identified in AAA (100% of cases). In the present study, medial degenerative aortic lesions (1, mild; 2, moderate; and 3, severe) significantly correlated with advanced age (>65 years; r=-0.39; P<0.01) and male sex (r=0.27; P<0.05). Significant correlations were also identified between atherosclerotic aortic lesions (1, mild; 2, moderate; and 3, severe) and advanced age (>65 years) (r=-0.40, P<0.01) or smoking (r=-0.29; P<0.05). Advanced age, male sex and smoking were determined to be the main risk factors for the development of degenerative aortic aneurysms.
本研究旨在根据关于非炎症性和炎症性病变的最新共识文件，分析手术切除的胸主动脉瘤（TAA）和腹主动脉瘤（AAA）标本的组织学特征。本研究还旨在建立与各种风险因素的关联。从罗马尼亚雅西心血管病研究所接受主动脉扩张手术的52例患者（38例男性和14例女性；年龄19 - 80岁）中收集主动脉壁标本。为进行组织学评估，对主动脉标本（39例TAA和13例AAA）进行苏木精 - 伊红染色、范吉森染色、阿尔辛蓝染色和莫瓦特五色染色。根据组织病理学状况的严重程度对标本进行评估和分级：弹性纤维断裂、中膜黏液样积聚、平滑肌细胞丢失和中膜纤维化。手术切除的主动脉段中动脉粥样硬化病变的严重程度分级如下：i）轻度 = 1；ii）中度 = 2；iii）重度 = 3。与TAA相关的风险因素为男性（80%）、吸烟（56%）、高血压（33%）和二叶式主动脉瓣（13%）。高龄（70岁）、男性（69%）和吸烟（54%）被确定为AAA的风险因素。组织病理学异常包括中膜退变（MD）（82%）、动脉粥样硬化（ATS）（42%）和主动脉炎（10%）。MD是TAA的主要组织病理学诊断，病变严重程度分级如下：轻度（8%的病例）、中度（44%的病例）和重度（31%的病例）。在AAA中发现严重动脉粥样硬化病变（100%的病例）。在本研究中，中膜退行性主动脉病变（1，轻度；2，中度；3，重度）与高龄（>65岁；r = -0.39；P<0.01）和男性（r = 0.27；P<0.05）显著相关。动脉粥样硬化性主动脉病变（1，轻度；2，中度；3，重度）与高龄（>65岁）（r = -0.40，P<0.01）或吸烟（r = -0.29；P<0.05）之间也存在显著相关性。高龄、男性和吸烟被确定为退行性主动脉瘤发生的主要风险因素。
