Taylor A J, Farb A A, Angello D A, Burwell L R, Virmani R
Cardiovascular Division, University of Virginia Health Sciences Center, Charlottesville, USA.
Chest. 1995 Sep;108(3):815-20. doi: 10.1378/chest.108.3.815.
Although cellular proliferation is considered one of the dominant processes leading to restenosis following coronary intervention, controversy exists over the extent of cellular replication in atherosclerotic tissue. Accordingly, we sought to investigate the level and clinicopathologic correlates of proliferative activity in atherosclerotic tissue obtained via directional coronary atherectomy (DCA).
Prospective observational study.
Tertiary care referral hospital.
Specimens retrieved via DCA from 37 lesions (primary, 26; restenosis, 11) were studied using single-label immunohistochemical staining for the proliferating cell nuclear antigen and basic fibroblast growth factor (bFGF).
Restenosis tissue was significantly more likely than primary tissue to contain areas of intimal hyperplasia (64 vs 23%; p < 0.03). However, the frequency of positive staining for proliferating cell nuclear antigen (PCNA) was similar in primary and restenosis lesions (25 vs 30%; p = NS), and the mean percentage of positive cells per slide was similar in the two groups. Positive immunostaining for bFGF was present in 20 lesions (61%), and tended to be more frequently seen in restenotic lesions (80 vs 52%; p = 0.25). However, there was no correlation or colocalization between immunostaining for bFGF and proliferating cell nuclear antigen. We found no clinicopathologic correlations with respect to clinical outcome.
Cellular replication, as measured by expression of the PCNA, occurs in a heterogeneous pattern in both primary and restenotic atherosclerotic tissue obtained from patients undergoing coronary intervention.
尽管细胞增殖被认为是冠状动脉介入治疗后导致再狭窄的主要过程之一，但对于动脉粥样硬化组织中细胞复制的程度仍存在争议。因此，我们试图研究通过冠状动脉定向旋切术（DCA）获得的动脉粥样硬化组织中增殖活性的水平及其临床病理相关性。
前瞻性观察性研究。
三级医疗转诊医院。
对通过DCA从37个病变（原发性病变26个，再狭窄病变11个）中获取的标本进行研究，采用单标记免疫组织化学染色检测增殖细胞核抗原和碱性成纤维细胞生长因子（bFGF）。
再狭窄组织比原发性组织更易出现内膜增生区域（64%对23%；p<0.03）。然而，原发性病变和再狭窄病变中增殖细胞核抗原（PCNA）阳性染色的频率相似（25%对30%；p=无显著性差异），两组每张切片阳性细胞的平均百分比也相似。20个病变（61%）中bFGF免疫染色呈阳性，在再狭窄病变中更常见（80%对52%；p=0.25）。然而，bFGF免疫染色与增殖细胞核抗原之间无相关性或共定位。我们未发现与临床结局相关的临床病理联系。
通过PCNA表达测量的细胞复制在接受冠状动脉介入治疗患者的原发性和再狭窄动脉粥样硬化组织中呈现异质性模式。
