| Hypertensive intracerebral hemorrhage(HICH), refers to a non-traumatic bleeding in cases of hypertension in the brain parenchyma. With rapid onset, quick progression and variations in clinical process, the prognosis for HICH is poor and the morbidity is very high. Damage to the hematoma surrounding tissue in hypertensive intracerebral hemorrhage is a complex pathological process, involving a wide range of mechanisms. Recent studies showed that several factors might be involved in the damaging process, among them the putative roles of TNF-α, VEGF and ET-1 had caused the concern of neuroscientists and clinicians.Objective:The purpose of this study is to elucidate the possible roles of TNF-α, VEGF and ET-1 expressions on the damage of hemorrhage surrounding brain tissue and to analyze the relationship between the expression of TNF-α, VEGF and ET-1 with clinical parameters, including gender, age, hypertension grade, GCS score, in HICH patients and to explore the correlation of the expression of the three factors in the process of HICH. Hopefully, the results will provide a theoretical basis for effective prevention and treatment of damage to the hematoma surrounding brain tissue in HICH.Methods: Forty cases of paraffin embedded normal brain tissue from neurosurgical surgical resection and autopsy and 40 cases of hemorrhage brain tissue with hematoma surrounding tissue were collected in department of pathology, Chengde Central Hospital from October 2012 to October 2014. All the cases of HICH in this study were confirmed by CT and MRI examination.The expressions of TNF-α, VEGF and ET-1 in normal brain tissue and the surrounding brain tissue in cerebral hemorrhage of HICH were comparatively studied with immunohistochemical staining.The expression levels of TNF-α, VEGF and ET-1 in normal brain tissue and the brain tissue surrounding hematoma in HICH were compared. The relationship between TNF-α, VEGF and ET-1 expression in the brain tissue surrounding hematoma and clinical parameters in HICH and the correlation of the three biomarkers in the process of HICH were analyzed. x2 test was used for the statistical analysis of experimental data. P<0.05 was considered statistically significant.Results: 1 The expressions of TNF-α, VEGF and ET1 in hematoma surrounding brain tissues of HICH were all significantly higher than that in normal brain tissues(P<0.05), suggesting that the three biomarkers were all involved in the damage to hematoma surrounding brain tissues of HICH. 1.1 The expression of TNF-α in hematoma surrounding brain tissues of HICH was related to hypertension stage and GCS scores. The TNF-α expression was significantly higher stage 3 and medium-high Score group than that in stage 1-2 and low score groups respectively(P<0.05). 1.2 In hematoma surrounding brain tissues of HICH patients with hypertension stage 3, the expression of VEGF was significantly higher than that in patients in stage 1-2. And higher VEGF expression was also found in patients with medium to high GCS scores(P<0.05). 1.3 The same expression pattern was found for ET-1 expression. 1.4 No significant relationship was found between TNF-α, VEGF and ET-1 expression and the gender and age of the patients(P<0.05). 2 The statistical analysis results showed that the expressions of TNF-α, VEGF and ET-1 was positively correlated in hematoma surrounding brain tissues of HICH(TNF-α vs VEGF: r=0.434, P<0.05; TNF-α vs ET-1:r=0.528, P<0.05;VEGF vs ET-I:r=0.459, P<0.05).Conclusions:1 The expressions of TNF-α, VEGF and ET1 were all significantly increased in hematoma surrounding brain tissues of HICH, suggesting that the these biomarkers were all involved in the damage to hematoma surrounding brain tissues of HICH.2 The expressions of TNF-α, VEGF and ET1 in hematoma surrounding brain tissues of HICH were all related to hypertension stage and GCS scores. The expression of the three makers was significantly higher stage 3 and medium-high Score group than that in stage 1-2 and low score HICH patients.3 Positive correlations among the expression of TNF-α, VEGF and ET-1 in hematoma surrounding brain tissues of HICH were found.Thus, the results in this study further confirmed that TNF-α, VEGF and ET-1 were all involved in the damage to hematoma surrounding brain tissues in HICH. |
