Study On Lymphatic Microvessels Density Of Middle And Inferior Nasal Concha

Objective: To investigate the lymphatic microvesselsdensity（LMVD）labeled by D2-40in middle and inferior nasal conchamucosa and study its relationship with the development of Nasal polyps.Method: This study is based on27cases of paraffin-embedded middleand inferior nasal concha tissue specimen and clinical data collected fromendoscopic sinus surgery of our Pathology department in the past twoyears. Inclusion criteria: select normal middle and inferior nasal conchaspecimen from nasal surgeries like nasal septum deviation, benign tumorsand cysts of sinus, nasal trauma. Specimen from acute and chronicsinusitis, cystic fibrosis, lymphatic system related diseases are ruled out.All cases should not include any history of nasal polyps, related familyhistory, allergic rhinitis and nasal tumors. Preoperative radiotherapy,chemotherapy and biological therapy, especially nasal hormone therapyshould not be applied before the surgery.27cases, including15malesand12females, meet with the above criteria with an average age of33.1(range from13to69). Test the expression of D2-40antigen in27cases ofmiddle and inferior nasal concha tissue by Envision method, calculate theD2-40positive lymphatic vessel density. Characteristics of positivestaining of lymphatic vessels: yellow brown ring like structure, mostlycomposed of single layer endothelial cells; lumen is in round, oval, occlusion cords shape, thin wall; no red blood cells, sometimeslymphocytes are seen in the lumen. Select hot spots from the area withlarge lymphatic vessels distribution, three hot spots are selected fromeach slice. One high power field (×100) image is captured from each3hot spots by the image acquisition system. Save the3images from eachslice separately, calculate the average number of lymphatic microvesselsof all3images of each specimen, record the number as the lymphaticmicrovessel density for each specimen. Results: positive rate of D2-40is100%(54/54) in the27cases with total54pathological biopsies ofmiddle and inferior nasal concha. The lymphatic vessel density (LVD, x±s) of the middle nasal concha mucosa tissue is3.42±1.67, and3.25±1.36in inferior nasal concha mucosa tissue. Apply paired-samples t testwith SPSS19.0statistical software by0.05. The lymphatic vessel densitydifference of middle and inferior nasal concha has no statisticalimportance (P＞0.05). Conclusion: This study helps us to recognize thefollowing points:①The D2-40immunohistochemical method applied onnasal lymphatic vessels staining are clear, specific; it obtains goodexperimental results, shows nasal lymphatic vessels structure clearly.②By comparing the lymphatic vessels structure of middle and inferior nasalconcha, we find out most of the lymphatic microvessels locate in themucosal lamina propria beneath epithelium, distribute in clumped pattern.③Initial findings suggest there is no significant difference in the number of lymphatic microvessels in the middle and inferior nasal concha. Fromthe above findings, it can preliminary conclude that the reason why morenasal polyps are seen in middle than inferior nasal concha does not lie inthe number of lymphatic microvessels in the nasal mucosa. Theconclusion is that the lymphatic vessels function of these primary sites isabnormal and can not guarantee normal water drainage in the mucousmembrane, eventually leads to the occurrence of edema. In a continuingprocess of inflammation, a large number of inflammatory mediators areinvolved. All of these inflammatory mediators increase the pathologicalprocesses of tissue edema, and ultimately inflammatory cells infiltrate,tissue restructure and finally lead to polyps.