Motegi H, Yamazaki M, Goto S, Mikata A, Moriya H
Department of Orthopaedic Surgery, School of Medicine, Chiba University, Japan.
Spine (Phila Pa 1976). 1998 Feb 1;23(3):305-10. doi: 10.1097/00007632-199802010-00004.
An experimental immunohistochemical investigation using an antibody for proliferating cell nuclear antigen. Surgically-extirpated specimens of posterior longitudinal ligament tissues from patients with hypertrophy of the posterior longitudinal ligament and other disorders of the cervical spine were analyzed.
To analyze the developmental mechanism of hypertrophy of the posterior longitudinal ligament, the authors evaluated the growth activity of cells in the posterior longitudinal ligament tissues by examining the immunolocalization of the proliferating cell nuclear antigen.
Although a number of cases of hypertrophy of the posterior longitudinal ligament have been reported, the pathophysiology of ligament hypertrophy is still unclear. It is well established that the proliferating cell nuclear antigen is a cell proliferation marker, and immunohistochemical analysis using an anti-proliferating cell nuclear antigen antibody is of value in assessing the cell growth activity of several tissues.
During anterior decompression surgery in the cervical spine, the authors extirpated posterior longitudinal ligament tissues in one piece from patients with hypertrophy of the posterior longitudinal ligament, ossification of the posterior longitudinal ligament, cervical disc herniation, and cervical spondylotic myelopathy. Midsagittal sections of the specimens were stained with an antibody against the proliferating cell nuclear antigen.
In cases of hypertrophy of the posterior longitudinal ligament, immunostaining with the proliferating cell nuclear antigen was detected in cells in the posterior longitudinal ligament, not only at the vertebral endplate level, but also at the midvertebral level. A similar distribution of proliferating cell nuclear antigen-positive cells was observed in cases of ossification of the posterior longitudinal ligament. In cases of cervical disc herniation, however, proliferating cell nuclear antigen-positive cells in posterior longitudinal ligament tissues were restricted to the vertebral endplate level. No immunostaining with the proliferating cell nuclear antigen was seen in posterior longitudinal ligament tissues in cases of cervical spondylotic myelopathy.
Cell growth activity was accelerated in posterior longitudinal ligament tissues in cases of hypertrophy of the posterior longitudinal ligament; such an unusual phenotype of posterior longitudinal ligament cells was also expressed in cases of ossification of cervical disc herniation and cervical spondylotic myelopathy. Therefore, up-regulation of the growth of posterior longitudinal ligament cells may contribute to the development of hypertrophy of the posterior longitudinal ligament, and some common regulatory mechanism(s) on the proliferation of posterior longitudinal ligament cells seem to underlie the development of hypertrophy of the posterior longitudinal ligament and ossification of the posterior longitudinal ligament.
一项使用增殖细胞核抗原抗体的实验性免疫组织化学研究。对来自后纵韧带肥厚及其他颈椎疾病患者的手术切除的后纵韧带组织标本进行分析。
为分析后纵韧带肥厚的发生机制，作者通过检测增殖细胞核抗原的免疫定位来评估后纵韧带组织中细胞的生长活性。
尽管已报道了许多例后纵韧带肥厚病例，但韧带肥厚的病理生理学仍不清楚。增殖细胞核抗原是一种细胞增殖标志物，使用抗增殖细胞核抗原抗体进行免疫组织化学分析在评估多种组织的细胞生长活性方面具有价值。
在颈椎前路减压手术中，作者从患有后纵韧带肥厚、后纵韧带骨化、颈椎间盘突出症和脊髓型颈椎病的患者中整块切除后纵韧带组织。标本的正中矢状切片用抗增殖细胞核抗原抗体染色。
在后纵韧带肥厚病例中，不仅在椎体终板水平，而且在椎体中部水平，后纵韧带中的细胞均检测到增殖细胞核抗原免疫染色。在后纵韧带骨化病例中观察到增殖细胞核抗原阳性细胞的类似分布。然而，在颈椎间盘突出症病例中，后纵韧带组织中的增殖细胞核抗原阳性细胞仅限于椎体终板水平。在脊髓型颈椎病病例的后纵韧带组织中未见到增殖细胞核抗原免疫染色。
后纵韧带肥厚病例中后纵韧带组织的细胞生长活性加快；这种后纵韧带细胞的异常表型在颈椎间盘突出症和脊髓型颈椎病骨化病例中也有表达。因此，后纵韧带细胞生长的上调可能促成后纵韧带肥厚的发生，而后纵韧带细胞增殖的一些共同调节机制似乎是后纵韧带肥厚和后纵韧带骨化发生的基础。
