The Expressions Of MMP-2 And CD68 In Nucleus Pulposus Of Lumbar Intervertebral Disc With Different Protrusion Types And Related Clinical Significance

Objective:To investigate the expressions of MMP-2 and CD68 in nucleus pulposus excised from patients of different types of lumbar disc herniation and to discuss the related clinical significance.Method:A total of 80 nucleus pulposus specimens from lumbar disc herniation patients in department of spine surgery department in Yanbian University hospital(2014.09-2017.01)were collected and classified according to surgical indications into pure protruding-type patient(group A,n=30),who was performed with percutaneous transforaminal endoscopic discectomy operation to extract the lumbar intervertebral disc,and giant protruding-type patient(group B,n=25)and prolapse free-type of patient(group C,n=25),who was performed with the unilateral Fenestration Laminectomy Discectomy operation to extract the lumbar intervertebral disc.The positive expressions of MMP-2 and CD68 in nucleus pulposus from all specimens were detected via immunohistochemical method.The relationships between positive expressions of MMP-2 and CD68 and protrusion types,protrusion sizes as well as painfulness severity were analyzed.MRI was applied to measure the sizes of protruded lumbar intervertebral discs,the percentage of maximum sagittal diameter of protrusion to that of spinal canal at the same level.Result:1)The positive rate of MMP-2 and CD68 in the prolapse free-type group were higher than that in the protruding-type group and giant protruding-type group(P<0.05),while the difference in expressions between protruding-type group and giant protruding-type group was not statistically significant.2)The positive expressions of MMP-2 and CD68 in nucleus pulposus were positively correlated with painfulness severity.3)The size percentage of protrusion in the giant protruding-type group was higher than that in the protruding-type group(P<0.05),however,there was no correlation between the percentage change of the size and the degree of pain score in the two groups.4)Preoperative VAS score and ODI score in prolapse free-type group were higher than those in protruding-type group and giant protruding-type group(P<0.05),while the diference in preoperative VAS score or ODI score between the protruding-type group and giant protruding-type group was not statistically significant.Conclusion:1.MMP-2 and CD68 were able to express in degenerated lumbar intervertebral discs.The positive expression in nucleus pulposus of different protrusion types were different the prolapse free-type protrusion showed higher expression than the protruding-type protrusion.2.The change of lumbar intervertebral disc sizes neither related to the positive expressions of MMP-2 and CD68 nor the degree of pain score.3.MMP-2 and CD68 were probably involved in the painfulness of lumbar disc herniation,and their expression levels were positively correlated with the degree of pain score.