Expression Of RANKL?OPG And IL-1? In Middle Ear Cholesteatoma Of Children And Adults

Objective: To detect the expression of nuclear factor k B receptor activating factor ligand(receptor activator nuclear factor-k B ligand,RANKL),osteoprotegerin(osteoprotegerin,OPG)and interleukin-1?(interleukin-1?,IL-1?)in middle ear cholesteatoma of children and adults,and the difference of bone destruction between children and adults.To analyze its correlation and to explore the molecular biological mechanism of middle ear cholesteatoma in children which is more destructive and invasive than that in adults.Methods: 1.Fresh specimens were collected from 50 patients with middle ear cholesteatoma,including 32 adults and 18 children.the control group was the normal external auditory canal skin of the ipsilateral ear.Fresh specimens were fixed in 10% formalin solution and made into paraffin sections.2.Combined with the patient's preoperative temporal bone spiral CT data,the bone destruction of the patients was observed during the operation,and the degree of bone destruction was graded.3.Immunohistochemical method(SP method)was used to detect the positive expression of RANKL,OPG and IL-1? in middle ear cholesteatoma and normal external auditory canal skin in different patient groups.The correlation and difference between the expression of the three in middle ear cholesteatoma and normal external auditory canal skin were analyzed,and the correlation between the degree of bone destruction and the expression of cytokines in middle ear cholesteatoma was analyzed.Result:1.Bone destruction: In children group,there were 3 cases of grade I,6 cases of II and 9 cases of III.Adult group: I degree 12 cases,II degree 12 cases,III degree 8 cases.there was no significant difference between the two groups(P > 0.05).2.The results of RANKL immunohistochemistry were as follows:(1)the expression of RANKL was positive in cholesteatoma tissues of children and adults,88.9% in children and 31.3% in adults.there was significant difference between the two groups(P < 0.05).(2)the expression of RANKL was positive in the normal external auditory canal skin of children and adults,38.9% in children and 12.5% in adults.there was significant difference between the two groups(P < 0.05).(3)the expression of RANKL in cholesteatoma tissue was significantly different from that in normal external auditory canal skin(P < 0.05).3.The results of 2.OPG immunohistochemistry were as follows:(1)the expression of OPG was positive in cholesteatoma tissues of children and adults,55.6% in children and 53.1% in adults.there was no significant difference between the two groups(P > 0.05).(2)the expression of OPG was positive in the normal external auditory canal skin of children and adults,61.1% in children and 53.1% in adults.there was no significant difference between the two groups(P > 0.05).(3)there was no significant difference in the expression of OPG between children and adults(P > 0.05).4.The results of IL-1? immunohistochemistry were as follows:(1)the expression of IL-1? was positive in middle ear cholesteatoma of children and adults,83.3% in children and 34.4% in adults(P < 0.05).(2)the expression of IL-1? was weakly positive in the normal external auditory canal skin of children and adults.There was significant difference between children group(44.4%)and adult group(12.5%)(P < 0.05).(3)the expression of IL-1? in cholesteatoma tissue was significantly higher than that in normal external auditory canal skin(P < 0.05).5.Correlation analysis:(1)there was no correlation between the expression of IL-1?,RANKL and OPG in middle ear cholesteatoma and the severity of bone destruction in middle ear cholesteatoma(P > 0.05);(2)both RANKL and IL-1? were found in middle ear cholesteatoma in children and adults.There was a positive correlation(P < 0.05)between),OPG and the expression of IL-1? and RANKL(P > 0.05).Conclusion: 1.The expression of RANKL and IL-1? in middle ear cholesteatoma in children is significantly higher than that in adults,which may be one of the molecular biological mechanisms that middle ear cholesteatoma in children is more destructive and invasive than adults.2.The expression of RANKL and IL-1? in the epithelium of middle ear cholesteatoma was significantly higher than that in normal skin tissue of external auditory canal,suggesting that both of them may play a role in the destruction and proliferation of cholesteatoma.3.There was a positive correlation between the expression of IL-1? and RANKL in middle ear cholesteatoma.It is suggested that the destruction and proliferation of cholesteatoma may play a synergistic role in the destruction and proliferation of cholesteatoma.4.The expression of IL-1?,RANKL and OPG in middle ear cholesteatoma was not significantly correlated with the degree of bone destruction,indicating that the three may not be involved in the process of bone destruction.