Study On Lymphatic Micro-vessels In Middle Turbinate With Nasal Polyps

Objective: Immunohistochemical method with D2-40was usedto observe lymphatic micro-vessels density (LVD) and lymphatic micro-vesselsarea (LVA) in middle turbinate (MT) with polyps or not. Transmission electronmicroscope (TEM) was applied to show the microstructure of lymphaticmicro-vessels, including mitochondrias and open connections betweenendotheliocytes. By contrasting the structure of lymphatic micro-vesselsbetween middle turbinate (MT) with polyps or not, we are trying to investigateits effection on pathogenesis of nasal polyps.Methods:1.We collected the clinical data of patients who were admitted tothe Otolaryngology department of Ya’an City People’s Hospital from February2012to September2012according to the inclusion and exclusion criteria. Thepatients were divided into an experimental group of12patients with polyps,and the others were divided into a control group of12patients with no polyps.The organization which was obtained from middle turbinate belonged to thosepatients was cut into two parts called the First-part and the End-part. TheFirst-part was dyed by hematoxylin–eosin and D2-40immunohistochemicalstaining, and the End-part was dyed by uranium-lead double attaining. TheFirst-part then was divided into three parts, including “normal area”,“borderarea” an “polyps area”.As also as the End-part, which include “upper region”,“central region” and “lower region”.2. The main experimentalmethods consist of HE staining, D2-40immunohistochemical staining(EnVision method) and uranium-lead dual-stained.3. A series of method isadopted to detected the experimental group and control group: the averagevalues of lymphatic micro-vessel density (LVD) and lymphatic micro-vesselscross-sectional area (LVA), the number of mitochondria in lymphaticmicro-vessel endothelial cells and the rate of open connection betweenendotheliocytes by TEM.4. These dates above were analyzed by SPSS18.0.Results:1.The average values of lymphatic micro-vessel density(LVD) in theexperimental group and control group were3.17±1.40and7.43±2.03(mean±standard deviation) respectively. The average values of lymphatic micro-vesselarea(LVA) in the experimental group and control group were0.01270±0.00458and0.01951±0.00369(mean±standard deviation) respectively. Using meanrandom independent samples t-test, we demonstrated that the differencesbetween the two groups in LVD and LVA were statistically significant (P<0.05).Then we detect LVD of “normal area”(0.92±1.00),“border area”(1.58±1.16),“polyps area”(3.17±1.40) in the experimental group and of“upper region”(1.17±1.03),“central region”(5.00±2.41) and “lowerregion”(7.43±2.03) in the control group, and LVA of “normal area”(0.01271±0.01333),“border area”(0.01489±0.00986),“polyps area”(0.01068±0.00451) in the experimental group and of “upper region”(0.01611±0.01354),“central region”(0.02371±0.00483) and “lower region” (0.01808±0.00363in the control group. Using mean random independentsamples t-test, we proved that the LVD and LVA in the “normal area” ofexperimental group and control group were not statistically significant (P>0.05),whereas the LVD and LVA in the “border area” and “polyps area” ofexperimental group were significantly decreased compared with the “centralregion” and “lower region” in the control group (P<0.05).2.The number ofmitochondria in lymphatic micro-vessel endothelial cells in the experimentalgroup and control group under electron microscope were26.03±3.69and31.02±2.53(mean±standard deviation). Mean random independent samplest-test showed that the differences between the two groups in the number ofmitochondria were statistically significant (P<0.05). Comparing the number ofmitochondria in “normal area”(26.75±3.12),“border area”(29.17±3.56)“polyps area”(42.58±6.56) of the experimental group and in the “upperregion”(32.17±5.20),“central region”(10.58±4.27)and the “lower region”(31.75±4.29) of the control group. The difference between the “border area” inexperimental group and the “central region” in control group, was statisticallysignificant (P<0.05); Besides, the difference between the “polyps area” inexperimental group and the “lower region” in control group, was statisticallysignificant, either(P<0.05). However, The difference between the “normalarea” in experimental group and the “upper region” in control group was notsignificant (P>0.05);4、There are45and573other connections in theexperimental group while4open connections and626other connections in the control group. The ratio of open connection were7.28%in experimental groupand0.63%in the control group. There are2open connections and197otherconnections in the “normal area” while1open connections and187otherconnections in the “upper region”. The ratio of open connection were1.01%in the “normal area” and0.53%in the “upper region”. There are36openconnections and181other connections in the “border area” while1openconnection and213other connections in the “central region”. The ratio ofopen connection were16.59%in the “border area” and0.47%. in the “centralregion”. There are7open connections and195other connections in the“polyps area” while2open connections and228other connections in the“lower region”, The ratio of open connection were3.47%in the “polyps area”and0.87%in the “lower region”.Conclusions:1. The cross-sectional area and the number of lymphaticmicro-vessel in nasal polyps were reduced, resulting poor drainage and thelocal area accumulation of large number inflammatory cells, inflammatorymediators, cytokines, macromolecular substances and bacteria.2. The depressof cross-sectional area and the number of lymphatic micro-vessel in the nasalpolyps surround tissue may cause the further general development of nasalpolyps3. Higher ratio of the open connection in nasal polyps and its lymphaticmicro-vessel endothelial cells in the surrounding tissue could exist a potentialcircumstances of lymph regurgitatio.