The Expression And Significance Of VEGF,Flt-4,PCNA In Cerebral Cavernous Malformation

PrefaceWith the development of neuroimagine and further understanding of the etiology of the cerebral cavernous malformation(CCM),the importance of CCM is gradually being realized by clinicians.Now CCM have become one of the major cerebravascular diseases,directly threatening human lives and health.At present the CCM keep many unknowns to us in the experimental field.The research topics proposed by CCM pathology and VEGF,Flt-4,PCNA expression in the CCM study,the occurrence of CCM-depth exploration,development and increasing mechanism.To further explore the pathogenesis of CCM and the potential for the optimal treatments for the disease.ObjectiveExplore the expression of VEGF,Flt-4,PCNA in the CCM,as well as it was the existence of correlation between cerebral cavernous malformation histopathological findings and the VEGF Flt-4 PCNA expression and cerebral cavernous malformation increasing.Material and method1,Experimental material35 patients who received a diagnosis of cerebral cavernous malformation were treated microsurgically and Pathologically confirmed at the department of neurosurgery sheng jing hospital china medical university between 2002～2008.Choose 9 cases of the normal brain blood vessels,10 cases of the skin cavernous hemangioma and 10 cases brain arteriovenous malformations as controls.2,Experimental methodwe retrospectively analysed histological characteristics of histologically confirmed 30 cases of the cerebral cavernous malformation,with H-E staining and light microscope observation.the specimens consisted of 35 cases of the cerebral cavernous malformation tissues,9 cases of normal brain vasculars were used as contrasts.we observed the construction features of the vascular wall involved in the cerebral cavernous malformation nidus and examined the expression of VEGF and their specific receptor Flt-4 in CCM specimens via immunohistochemical techniques,light microscope to observe and record the parts of staining and staining intensity were grade,calculation positive index.Do rank sum test to compare different group level data and use table of four Fisher exact test to comparision group by SPSS for Windows 13.0.When P＜0.05,the diserepaney have significance.35 CCM cases of resection or biopsy in our hospital were collected.Another 9 cases of small blood vessel in normal brain,10 cases of AVM and 10 cases of the skin cavernous hemangioma were collected as contrasts.The expression of proliferating cell nuclear antigen(PCNA) was assessed with monoclonal antibody of PCNA by immunohistochemical method.Each group calculated prolifer index(PI).Measurement data to mean±standard deviation(x±s) express.group compared with group t test to compare.When P＜0.05,the diserepaney have significance.Result1,Pathological observations30 cases of CCM to see 16 cases of thrombosis,7 cases of organic and 29 cases of hematoma formation and focus to sea hemosiderosis weeks.Complete or dense sponge-like structure of the type found in 6 cases,simple plexifoem see only 3 cases and the remaining lesions are hybrid structures.2,VEGF and its receptor Flt-4-specific immunohistochemical staining resultspositive staining of VEGF and its specific receptor Flt-4 in CCM,normal brain vasculars.their was statistically significant difference between the two groups(p＜0.05)compare the positive rate of them for the patients with different nidus sizes,there was statistically significant difference between them.(p＜0.05).3,PCNA immunohistochemical staining results Proliferation index(PI) of endothelia cells in CCM was(12.28±4.42).There wasn't significant difference(t=1.97,P＞0.05)from PI of endotheliacells of small blood vessels in normal brain(9.24±2.52),wasn't significant difference(t=0.51,P＞0.05)from PI of endotheliacells of AVM(11.47±4.60) while significant difference did exist compared with PI of turnor cells in the skin cavernous hemangioma(51.81±9.91 t =-12.27,P＜0.01)Conclusion1.This experiment prompted that the sinusoidal caveity,extermal bleeding,thrombosis, machines and calcification leading to sinus cavity expansion may be related to the increase of the cerebral cavernous malformation.2.Show that it is a role to play that VEGF and its specific receptor Flt-4 in the occurrence and development of CCM.3.Abnormal proliferation of endothelia cells may not relate to the occurrence and development of CCM,which might be nonmalignant.CCM and AVM should be classified in the central nervous system vascular malformations.