泪腺良性淋巴上皮病变的病理特点及IgG4和C3的表达
|
摘要
目的探讨IgG4和C3在泪腺良性淋巴上皮病变发生发展中的作用。方法收集2010年7月至2018年5月就诊于承德医学院附属医院眼科、解放军总医院眼科15例(15眼)泪腺良性淋巴上皮病变患者的泪腺肿物为试验组,10例(10眼)因其他疾病而行眶内容物摘除术的正常泪腺组织标本为对照组。采用HE染色法观察2组泪腺病理形态学变化及其组织病理学特点,采用免疫组织化学染色法检测2组泪腺组织中IgG4、C3的表达,并对二者表达相关性进行分析。结果 HE染色结果显示,对照组泪腺由正常腺泡及导管组成,导管上皮细胞排列整齐,细胞结构清晰,其间有少量的淋巴细胞;试验组泪腺组织中可见大量淋巴细胞、浆细胞浸润,淋巴滤泡形成,其间可见上皮-肌上皮岛结构改变,同时伴有不同程度纤维化。IgG4在试验组阳性表达面积为(30 934.80±16 057.17)像素,对照组阳性表达面积为(325.42±204.43)像素,试验组中明显高于对照组(t=-7.38,P=0.000);C3在试验组阳性表达面积为(43 169.49±33 206.60)像素,对照组阳性表达面积为(323.24±271.29)像素,试验组中明显高于对照组,差异有统计学意义(t=-5.00,P=0.000)。试验组中IgG4与C3表达无相关性(r=-0.137,P=0.671)。结论泪腺良性淋巴上皮病变患者的泪腺发生了明确的病理改变,这可能与IgG4和C3在泪腺中的高表达有关。
Objective To investigate the role of IgG4 and C3 in the development of lacrimal gland benign lymphoepithelial lesion.Methods A total of 25 eyes of 25 patients' lacrimal gland from July 2010 to May 2018 in Department of Ophthalmology,Affiliated Hospital of Chengde Medical College and the Third Medical center of Chinese PLA General Hospital.Among them,fifteen patients(15 eyes) with lacrimal gland benign lymphoepithelial lesion were collected as experimental group,and the lacrimal gland tumor tissues were harvested,while 10 patients(10 eyes) with orbit evisceration for other diseases were collected as the control group,and the normal lacrimal gland tissues were harvested.Hematoxylin-eosin(HE) staining was used to observe pathomorphology changes of and histopathological features of lacrimal gland.Immunohistochemical SP method was used to detect the expression of IgG4 and C3 in lacrimal gland.The expression of IgG4 and C3 were analyzed.Results HE staining showed that the lacrimal gland of the control group consisted of normal acinar cells and ducts.The ductal epithelial cells were arranged neatly and the cell structure was clear with a small amount of lymphocytes.And a large number of lymphocytes and plasma cells infiltrated into the lacrimal gland tissue of the experimental group,and lymphoid follicles were formed.The structure of the epithelial myoepithelial islands was observed.In the experimental group,the lacrimal gland was accompanied by different degrees of fibrosis,which was significantly changed compared with the normal lacrimal gland of the control group.The positive expression area of IgG4 in the experimental group was(30 934.80±16 057.17) pixel,and the positive expression area of the control group was(325.42±204.43) pixel,the expression of IgG4 was significantly higher in the experimental group than in the control group(t=-7.38,P=0.000).The positive expression area of C3 in the experimental group was(43 169.49±33 206.60)pixel,and the positive expression area of the control group was(323.24±271.29) pixel,the expression of C3 was significantly higher in the experimental group than in the control group(t=-5.00,P=0.000).There was no correlation between IgG4 and C3 expression in the experimental group(r=-0.137,P=0.671).Conclusion A clear pathological change in the lacrimal gland of patients with lacrimal gland benign lymphoepithelial lesion can be observed,which may be associated with high expression of IgG4 and C3 in the lacrimal gland.
Objective To investigate the role of IgG4 and C3 in the development of lacrimal gland benign lymphoepithelial lesion.Methods A total of 25 eyes of 25 patients' lacrimal gland from July 2010 to May 2018 in Department of Ophthalmology,Affiliated Hospital of Chengde Medical College and the Third Medical center of Chinese PLA General Hospital.Among them,fifteen patients(15 eyes) with lacrimal gland benign lymphoepithelial lesion were collected as experimental group,and the lacrimal gland tumor tissues were harvested,while 10 patients(10 eyes) with orbit evisceration for other diseases were collected as the control group,and the normal lacrimal gland tissues were harvested.Hematoxylin-eosin(HE) staining was used to observe pathomorphology changes of and histopathological features of lacrimal gland.Immunohistochemical SP method was used to detect the expression of IgG4 and C3 in lacrimal gland.The expression of IgG4 and C3 were analyzed.Results HE staining showed that the lacrimal gland of the control group consisted of normal acinar cells and ducts.The ductal epithelial cells were arranged neatly and the cell structure was clear with a small amount of lymphocytes.And a large number of lymphocytes and plasma cells infiltrated into the lacrimal gland tissue of the experimental group,and lymphoid follicles were formed.The structure of the epithelial myoepithelial islands was observed.In the experimental group,the lacrimal gland was accompanied by different degrees of fibrosis,which was significantly changed compared with the normal lacrimal gland of the control group.The positive expression area of IgG4 in the experimental group was(30 934.80±16 057.17) pixel,and the positive expression area of the control group was(325.42±204.43) pixel,the expression of IgG4 was significantly higher in the experimental group than in the control group(t=-7.38,P=0.000).The positive expression area of C3 in the experimental group was(43 169.49±33 206.60)pixel,and the positive expression area of the control group was(323.24±271.29) pixel,the expression of C3 was significantly higher in the experimental group than in the control group(t=-5.00,P=0.000).There was no correlation between IgG4 and C3 expression in the experimental group(r=-0.137,P=0.671).Conclusion A clear pathological change in the lacrimal gland of patients with lacrimal gland benign lymphoepithelial lesion can be observed,which may be associated with high expression of IgG4 and C3 in the lacrimal gland.
引文
[1] LI F M.Chinese ophthalmology[M].2nd ed.Beijing:People’s Medical Publishing House,2004:909.李凤鸣.中华眼科学[M].2版.北京:人民卫生出版社,2004:909.
[2] LI J,GE X,MA J M,SHI J T,CUI Y X.Study on clinical manifestations and diagnosis of benign lymphoid epithelial lesions in lacrimal gland[J].J Clin Ophthalmol,2012,20(3):193-195.李静,葛心,马建民,史季桐,崔忆辛.泪腺良性淋巴上皮病变临床表现及诊断思路的研究[J].临床眼科杂志,2012,20(3):193-195.
[3] YAMAMOTO M,TAKAHASHI H,ISHIGAMI K,YAJIMA H,SHIMIZU Y,TABEYA Y,et al.Relapse patterns in IgG4-related disease[J].Ann Rheum Dis,2012,71(10):1755.
[4] LEE S,TSIRBAS A,MCCANN J D,GOLDBERG R A.Mikulicz’s disease:a new perspective and literature review[J].Eur J Ophthalmol,2006,16(2):199-203.
[5] LI J,GE X,MA J M.Immunohistochemical study of benign lymphoid epithelial lesions in lacrimal gland[J].Rec Adv Ophthalmol,2015,35(5):439-441.李静,葛心,马建民.泪腺良性淋巴上皮病变免疫组织化学研究[J].眼科新进展,2015,35(5):439-441.
[6] HE X J,XING L,LIU H G.Clinicopathological analysis of IgG4-related diseases in ocular appendages[J].Chin J Pathol,2014,43(12):799-804.何小金,刑莉,刘红刚.眼附属器IgG4相关性疾病的临床病理分析[J].中华病理学杂志,2014,43(12):799-804.
[7] PIAO Y S,YU W L,HE C Y,YUE C L,LIU H G.Clinical and pathological analysis of 13 cases of IgG4-related diseases involving lacrimal gland/ parotid gland and nasal cavity and sinus[J].Chin J Pathol,2016,45(3):180-185.朴颖实,于文玲,何春燕,岳常丽,刘红刚.同时累及泪腺/涎腺及鼻腔鼻窦的IgG4相关性疾病13例临床病理分析[J].中华病理学杂志,2016,45(3):180-185.
[8] MA J M,LI J.Research on IgG4-related orbital diseases[J].Chin J Exp Ophthalmol,2015,33(12):1060-1063.马建民,李静.重视IgG4相关性眼眶疾病的研究[J].中华实验眼科杂志,2015,33(12):1060-1063.
[9] KAKUDO K,LI Y,HIROKAWA M,OZAKI T.Diagnosis of Hashimoto’s thyroiditis and IgG4-related sclerosing disease[J].Pathol Int,2011,61(4):175-183.
[10] KAKUDO K,LI Y,TANIGUCHI E,MORI I,OZAKI T,NISHIHARA E,et al.IgG4-related disease of the thyroid glands[J].Endocr J,2012,59(4):273-281.
[11] YAMADA K,KAWANO M,INOUE R,HAMANO R,KAKUCHI Y,FUJII H,et al.Clonal relationship between infiltrating immunoglobulin G4 (IgG4)-positive plasma cells in lacrimal glands and circulating IgG4-positive lymphocytes in Mikulicz’s disease[J].Clin Exp Immunol,2008,152(3):432-439.
[12] YU W K,KAO S C,YANG C F,LEE F L,TSAI C C.Ocular adnexal IgG4-related disease:clinical features,outcome,and factors associated with response to systemic steroids[J].Jpn J Ophthalmol,2015,59(1):8-13.
[13] GUO J H,TIAN Y M,MA M L,LIU Y,GAO X W.Clinical pathology observation on orbit IgG4 related disease[J].Int Eye Sci,2015,15(9):1658-1660.
[14] NIZAR A H,TOUBI E.IgG4-related disease:case report and literature review[J].Auto Immun Highlights,2015,6(1-2):7-15.
[15] GAO L L,BAI Y,PANG Q X.Systematic generation of complement component C3[J].Chin J Biochem Mol Biol,2014,30(9):863-869.高丽丽,白云,庞秋香.补体成分C3的系统发生[J].中国生物化学与分子生物学报,2014,30(9):863-869.
[16] KIMURA A,SAKAGUCHI E,NONAKA M.Multi-component complement system of Cnidaria:C3,Bf,and MASP genes expressed in the endodermal tissues of a sea anemone,Nematostella vectensis[J].Immunobiology,2009,214(3):165-178.
[17] LI J,GE X,MA J M,WANG Y N,LIU W.Detection of differentially expressed genes in benign lymphoid epithelial lesions of the lacrimal gland and lesions of orbital cavernous hemangioma[J].Chin J Exp Ophthalmol,2016,34(10):878-882.李静,葛心,马建民,王霄娜,刘骁.泪腺良性淋巴上皮病变与眼眶海绵状血管瘤患者病变标本中差异表达基因的检测[J].中华实验眼科杂志,2016,34(10):878-882.
[18] LI J,GE X,WANG X N,LIU X,MA J M.Complement system in the pathogenesis of benign lymphoepithelial lesions of the lacrimal gland[J].PLoS One,2016,11(2):e0148290.
[19] SU J.Molecular pathogenesis of idiopathic membranous nephropathy[D].Nanjing:Nanjing University,2005.苏健.特发性膜性肾病分子发病机制研究[D].南京:南京大学,2005.
[20] LIN W F.Relationship between antiphospholipid A2 receptor antibody and idiopathic membranous nephropathy[D].Beijing:Peking Union Medical College,Chinese Academy of Medical Sciences,2016.林伟锋.抗磷脂酶A2受体抗体与特发性膜性肾病的关系研究[D].北京:北京协和医学院中国医学科学院,2016.
[2] LI J,GE X,MA J M,SHI J T,CUI Y X.Study on clinical manifestations and diagnosis of benign lymphoid epithelial lesions in lacrimal gland[J].J Clin Ophthalmol,2012,20(3):193-195.李静,葛心,马建民,史季桐,崔忆辛.泪腺良性淋巴上皮病变临床表现及诊断思路的研究[J].临床眼科杂志,2012,20(3):193-195.
[3] YAMAMOTO M,TAKAHASHI H,ISHIGAMI K,YAJIMA H,SHIMIZU Y,TABEYA Y,et al.Relapse patterns in IgG4-related disease[J].Ann Rheum Dis,2012,71(10):1755.
[4] LEE S,TSIRBAS A,MCCANN J D,GOLDBERG R A.Mikulicz’s disease:a new perspective and literature review[J].Eur J Ophthalmol,2006,16(2):199-203.
[5] LI J,GE X,MA J M.Immunohistochemical study of benign lymphoid epithelial lesions in lacrimal gland[J].Rec Adv Ophthalmol,2015,35(5):439-441.李静,葛心,马建民.泪腺良性淋巴上皮病变免疫组织化学研究[J].眼科新进展,2015,35(5):439-441.
[6] HE X J,XING L,LIU H G.Clinicopathological analysis of IgG4-related diseases in ocular appendages[J].Chin J Pathol,2014,43(12):799-804.何小金,刑莉,刘红刚.眼附属器IgG4相关性疾病的临床病理分析[J].中华病理学杂志,2014,43(12):799-804.
[7] PIAO Y S,YU W L,HE C Y,YUE C L,LIU H G.Clinical and pathological analysis of 13 cases of IgG4-related diseases involving lacrimal gland/ parotid gland and nasal cavity and sinus[J].Chin J Pathol,2016,45(3):180-185.朴颖实,于文玲,何春燕,岳常丽,刘红刚.同时累及泪腺/涎腺及鼻腔鼻窦的IgG4相关性疾病13例临床病理分析[J].中华病理学杂志,2016,45(3):180-185.
[8] MA J M,LI J.Research on IgG4-related orbital diseases[J].Chin J Exp Ophthalmol,2015,33(12):1060-1063.马建民,李静.重视IgG4相关性眼眶疾病的研究[J].中华实验眼科杂志,2015,33(12):1060-1063.
[9] KAKUDO K,LI Y,HIROKAWA M,OZAKI T.Diagnosis of Hashimoto’s thyroiditis and IgG4-related sclerosing disease[J].Pathol Int,2011,61(4):175-183.
[10] KAKUDO K,LI Y,TANIGUCHI E,MORI I,OZAKI T,NISHIHARA E,et al.IgG4-related disease of the thyroid glands[J].Endocr J,2012,59(4):273-281.
[11] YAMADA K,KAWANO M,INOUE R,HAMANO R,KAKUCHI Y,FUJII H,et al.Clonal relationship between infiltrating immunoglobulin G4 (IgG4)-positive plasma cells in lacrimal glands and circulating IgG4-positive lymphocytes in Mikulicz’s disease[J].Clin Exp Immunol,2008,152(3):432-439.
[12] YU W K,KAO S C,YANG C F,LEE F L,TSAI C C.Ocular adnexal IgG4-related disease:clinical features,outcome,and factors associated with response to systemic steroids[J].Jpn J Ophthalmol,2015,59(1):8-13.
[13] GUO J H,TIAN Y M,MA M L,LIU Y,GAO X W.Clinical pathology observation on orbit IgG4 related disease[J].Int Eye Sci,2015,15(9):1658-1660.
[14] NIZAR A H,TOUBI E.IgG4-related disease:case report and literature review[J].Auto Immun Highlights,2015,6(1-2):7-15.
[15] GAO L L,BAI Y,PANG Q X.Systematic generation of complement component C3[J].Chin J Biochem Mol Biol,2014,30(9):863-869.高丽丽,白云,庞秋香.补体成分C3的系统发生[J].中国生物化学与分子生物学报,2014,30(9):863-869.
[16] KIMURA A,SAKAGUCHI E,NONAKA M.Multi-component complement system of Cnidaria:C3,Bf,and MASP genes expressed in the endodermal tissues of a sea anemone,Nematostella vectensis[J].Immunobiology,2009,214(3):165-178.
[17] LI J,GE X,MA J M,WANG Y N,LIU W.Detection of differentially expressed genes in benign lymphoid epithelial lesions of the lacrimal gland and lesions of orbital cavernous hemangioma[J].Chin J Exp Ophthalmol,2016,34(10):878-882.李静,葛心,马建民,王霄娜,刘骁.泪腺良性淋巴上皮病变与眼眶海绵状血管瘤患者病变标本中差异表达基因的检测[J].中华实验眼科杂志,2016,34(10):878-882.
[18] LI J,GE X,WANG X N,LIU X,MA J M.Complement system in the pathogenesis of benign lymphoepithelial lesions of the lacrimal gland[J].PLoS One,2016,11(2):e0148290.
[19] SU J.Molecular pathogenesis of idiopathic membranous nephropathy[D].Nanjing:Nanjing University,2005.苏健.特发性膜性肾病分子发病机制研究[D].南京:南京大学,2005.
[20] LIN W F.Relationship between antiphospholipid A2 receptor antibody and idiopathic membranous nephropathy[D].Beijing:Peking Union Medical College,Chinese Academy of Medical Sciences,2016.林伟锋.抗磷脂酶A2受体抗体与特发性膜性肾病的关系研究[D].北京:北京协和医学院中国医学科学院,2016.