Expression Of TGF-a, MMP-9 And MVD In Human Middle Ear Cholesteatoma

Objective:To analyze the expression of transforming growth factor alpha(TGF-a),matrix metalloproteinase-9(MMP-9) and microvessel density(MVD) in human middle ear cholesteatoma and to investigate the correlation between their expression and the ability of erosion of cholesteatoma.Methods:1.44 cases of cholesteatoma specimens were collected at time of surgery,and 10 cases of the skin of external acoustic meatus were the control group.All of the specimens were fixed immediately and made into paraffin sections.2.44 cases were divided into five groups according to the ability of erosion of cholesteatoma:Sl:6 cases;S2:5 cases;S3:15 cases;S4:13 cases;S5:5 cases.3.Immunohistochemical staining was used to detect the expression of TGF-a,MMP-9 and collagen type IV in the cholesteatoma and the skin of external acoustic meatus.The computer image quantitative analysis was used to examin the expression of TGF-a,MMP-9.The microvasculars of cholesteatoma were measured by MVD which were immunohistostained with collagen type IV.4.All datas were analyzed statiscally by software SPSS 10.0. Results:1. The expression of TGF-a in cholesteatoma and the skin of external acoustic meatus:The positive immunostaining of TGF-a appeared all the layers,TGF-a protein was localized mostly in the cytoplasm,and it showed the tendency of gradual increasing from basal layer to corneous layer.The skin of external acoustic meatus showed weakly positive.2. The expression of MMP-9 in cholesteatoma and the skin of external acoustic meatus:The positive immunostaining of MMP-9 appeared all the layers,MMP-9 protein was localized mostly in the cytoplasm,and it showed the tendency of gradual increasing from basal layer to corneous layer.The skin of external acoustic meatus showed weakly positive.3. The expression of collagen type IV in cholesteatoma and the skin of external acoustic meatus:The microvasculars of cholesteatoma matrix were plentiful and close.But the microvasculars of the skin of external acoustic meatus were less and more raritas than of cholesteatoma.4.The gray scale value of TGF-a,MMP-9:(1)The mean gray scale value of TGF-a was 120.73±11.87 in cholesteatoma and 145.66±3.44 in the skin of external acoustic meatus,and there was statistical significance between the groups (t=11.19,P<0.05).(2) The mean gray scale value of MMP-9 was 119.60±14.20 in cholesteatoma and 154.73±6.93 in the skin of external acoustic meatus,and there was statistical significance between the groups (t=11.46,P<0.05).5.The mean MVD was 37.85±3.93/mm~2(n=44) in cholesteatoma and 13.28±2.58/mm~2(n=10) in the skin of external acoustic meatus,and there was statistical significance between the groups(t=18.81,P<0.05).6. The expression of TGF-a,MMP-9 and MVD increased as the ability of erosion of cholesteatoma strengthened.7.There was positive correlation among TGF-a,MMP-9 and MVD(P<0.05).Conclusion:1. There was positive correlation between TGF-a and MVD, there was also positive correlation between MMP-9 and MVD,so TGF-a and MMP-9 may play an important role in angiogenesis of human middle ear cholesteatoma.2.There was positive correlation between TGF-a and MMP-9,so they may have been synergistic action in angiogenesis of human middle ear cholesteatoma.3.There was a direct ratio between TGF-a,MMP-9,MVD and the ability of erosion of cholesteatoma,so there may be a closely relation between TGF-a,MMP-9, MVD and the ability of erosion of cholesteatoma.