The Experimental Study On The Pathological Pathogenesis Of Vascular Anomalies And The Treatment With High Intensity Focused Ultrasound

PART ONESTUDY ON THE PATHOLOGICAL PATHOGENESIS OF VASCULAR ANOMALIESObjectives:To explore the different expression level of VEGF, FGF-2, TIMP-1, IGF-Ⅱand GLUT1 in Vascular malformations, RICH, and different phases of HOI.Methods: Seventy-four specimens of paraffin-embedded tissue were collected from the children with skin vascular anomalies. All the patients hadn't gotten any treatment before surgery resection. The specimens were conducted with common HE staining and pathological examination based on the clinical data. The expression of GLUT 1, VEGF, FGF-2, IGF-Ⅱand TIMP-1 were determined by ElivisionTM two-step immunohistochemical method.Results: The expression of GLUT1 was present in the microvascular endothelium at the three periods of HOI, while that was not detected in the vascular malformations and RICH. The positive expression rate of VEGF, FGF-2, IGF-Ⅱ and TIMP-1 were 90%, 80%, 95% and 45% in the proliferating HOI group; 80%, 100%, 27% and 80% in the involuting HOI group; 11%, 56%, 11% and 22% in the involuted HOI group; 25%, 100%, 75% and 25% in the RICH group; 12%, 8%, 0% and 8% in the vascular anomalies group. There was statistical difference of the positive expression rate of VEGF among the proliferating, involuting HOI groups and vascular malformations(χ2=33.34,P<0.01). Significant difference of the positive expression rate of FGF-2 was found among the proliferating, involuting and involuted HOI groups and vascular malformations(χ2=43.18,P<0.01). The positive expression intensity of FGF-2 in the proliferating, involuting and involuted groups were markedly different(H=32.95,P<0.01). Statistical difference of the positive expression rate of IGF-Ⅱ was found among the proliferating, involuting HOI groups and vascular malformations(χ2=44.47,P<0.01). The positive expression intensity of IGF-Ⅱ in the proliferating, involuting and involuted HOI groups were markedly different(H=32.45,P<0.01). Statistical significance of the positive expression rate of TIMP-1 existed among the proliferating, involuting and involuted HOI groups and vascular malformations(χ2=21.84,P<0.01). The positive expression rate of FGF-2 and IGF-Ⅱin the vascular malformations and RICH groups were both markedly different (P=0.001).Conclusions: 1. Proliferating and involuting of HOI was a continuous process, in which multiple factors participated and IGF-Ⅱ may play a main role in the spontaneous involuting of HOI. Glut1 can be utilized as a specific marker for HOI to be distinguished from other vascular anomalies.2. The expression regularity of VEGF, FGF-2, IGF-Ⅱ and TIMP-1 in HOI tissue can afford theory evidence for detecting these markers in the blood and urine samples from HOI patients to identify HOI and its stage. 3. RICH is a kind of tumor composed of hyperplastic capillary endothelial cells, which is different from HOI not only in tissue architexture but also in clinical manifestations. 4. The endothelial cells of vascular malformations are not obviously hyperplasic. VEGF, FGF-2, IGF-Ⅱ and TIMP-1 all are the good markers for differentiating vascular malformations from HOI.