The Study Of TGF-β And CTGF In Adult Avascular Necrosis Of The Femoral Head

objective: We discuss the relationship between TGF-β&CTGF and thepathology Of ANFH through observation of the histopathologic ANFH andinvestigation the expression of TGF-βand CTGF in ANFH byimmunohistochemical analysis, thereby, try to elucidate the pathogenesisof ANFH at the level of molecular pathology.Methods: The specimens were 40 femoral heads from patients undergoingtotal hip replacement including 20 cases of ANFH (pathology group)and20 cases of the femoral head fracture under the capsule(control group). Wecollect the specimens from the sites of bone necrosis and neighborhood inthe femoral heads, and the specimens for control group correspondent topathology group. (1) observation the basic pathologic changes of ANFHunder light microscope stained by HE (2) search the characteristics ofthe expression of TGF-βand CTGF by immunohistochemical analysis. (3)statistics analysis(Npar Tests)using software SPSS.Results:(1)histopathologic observation:①we found bone cells manifestednecrosis collapse, and karyopyknosis in pathological group. The bonelacunas were hollow, the circumferential lamella turned turbulent and a partof them dissolved. A few new bone can be seen around dead bone in the femoral heads. congestion of the tissue around the necrotic bone andinfiltration of lymphatic cells and plasma cells also are observed, and thereare proliferation of fibrous tissue and granulomatous tissue in the gross hap.②In control group, circumferential lamella were excessive and parallell inthe order. Bone lacunas locate in the bone lamella or among them, singleand separately, stained by blue-purple. Bone cell lies in lacuna. Nonecrosis and granulation tissues or fibrous tissues can be found in control.(2) Immunohistochemical analysis: The expressions of TGF-β, CTGFprotein are both positive in the part of necrotic femoral head and thecircumferential of necrotic bone. But the later is higher, furthmore, thepositive immunostaining were more ofen seen in granulomatous tissue andfibrous tissue. The immunostaining was located in the cell plasma orin the nuclear occasionally.①The expressions of TGF-β, CTGF are bothlower in the part of necrotic femoral head than that in the control withstatistical significance at 0.05 level(P＜0.05).②The expressions ofTGF-β, CTGF are both higher in the circumferential part of necrotic bonethan that in the control with statistical significance at 0.05 level(P＜0.05).③The expressions of TGF-β, CTGF are both higher in the circumferentialpart of necrotic bone than, that in the part of necrotic femoral head withstatistical significance at 0.05 level(P＜0.05).Conclusion:1. The proliferation of granulomatous tissue and fibrous tissues is significant pathologic changes in the necrotic femoral head and plays animportant role in the development of the necrosis of femoral head.2,The expressions of TGF-13 ,CTGF in the circumferential part ofnecrotic bone is higher, suggestd that the good reparative ability occur in it.Their expressions are related to the formation of new bone and hyperplasiaof granulomatous tissue and fibrous tissue. They play important roles inthe formation necrotic histopathology of femoral head.3,The expressions of TGF-β, CTGF in the part of necrotic bone islower, demonstrating that its'reparative abilityis poor. The failure in therevival of necrotic bone may contribute to the lower expressions ofTGF-β, CTGF4. Data suggest that the overexpressions of TGF-β, CTGF are close tohyperplasia & fibrosis of granulomatous and fibrous tissue, and may play arole in the.development of the necrosis of femoral head.