作　　者： (徐婷）; (杨雁）; (赵丽）; (周丹丹）; (张燕）;

机构地区： 四川大学华西医院消化内科,成都610041

出　　处： 《四川大学学报（医学版）》 2017年第5期721-726,共6页

摘　　要： 目的测定肿瘤坏死因子样凋亡弱诱导因子(TWEAK)/成纤维细胞生长诱导因子14(Fn14)在克罗恩病(CD)患者血清及结肠组织中的表达,初步探讨TWEAK/Fn14是否可作为预测CD肠壁纤维化的指标之一。方法收集67例CD患者和33例健康对照者的外周血标本,采用ELISA法检测血清TWEAK水平。同时收集29例接受手术治疗的CD患者结肠手术标本和15例接受手术治疗的结肠癌患者手术标本中正常结肠组织,采用免疫组化法测定结肠组织中TWEAK、Fn14的表达水平。采用免疫荧光法计数结肠组织中Fn14、α-平滑肌肌动蛋白(α-SMA)双阳性细胞数。结果 CD患者血清TWEAK的表达水平较对照组升高(P<0.01),其中合并肠狭窄或肠梗阻的患者升高尤为明显(P<0.05)。血清TWEAK水平与结肠手术史(r=0.295,P=0.015)、肠狭窄(r=0.290,P=0.017)及肠梗阻(r=0.453,P=0.000 1)相关。ROC分析提示TWEAK用于预测CD并发肠壁狭窄的曲线下面积为0.67(95%CI:0.54~0.80,P=0.020)。免疫组化结果显示合并肠梗阻的CD患者结肠组织中TWEAK和Fn14的表达水平高于无肠梗阻的CD患者和对照组(P<0.05)。免疫荧光结果显示Fn14和α-SMA双阳性的细胞数量在伴有肠梗阻的CD患者结肠黏膜中明显增加(P<0.05)。结论 TWEAK/Fn14通路可能在CD肠壁纤维化中扮演着重要角色。 Objective To investigate the expression of tumor necrosis factor-like weak inducer of apoptosis （TWEAK）/ fibroblast growth factor-inducible 14 （Fn14） in the serum and colon tissue of Crohn＇s disease （CD） and to elucidate whether the expression of TWEAK/Fn14 can be used as an indicator for intestinal fibrosis. Methods Blood samples from 67 CD patients and 33 healthy controls were collected to measure the level of TWEAK by ELISA. Meanwhile, colon samples from 29 CD patients received colectomy and the normal colon tissues from 15 patients with colon cancer were included. The expression of TWEAK and Fn14 in colon samples was analyzed by immunohistochemistry （IHC）. The number of the ceils with Fn14, a-smooth muscle actin （a-SMA） double positive was measured by immunofluorescent double staining. Results The level of serum TWEAK in CD patients was higher than that in healthy controls （P〈0. 01）, which was positive correlated with colectomy （r= 0. 295, P = 0. 015）, intestinal stenosis （r=0. 290, P=0. 017） and intestinal obstruction （r=0. 453, P〈0. 000 1）. ROC analysis displayed the area under the curve of serum TWEAK for predicting intestinal stenosis in CD patients was 0. 67 （95 % CI O. 54-0.80,P= 0. 020）. IHC results showed that the expression of TWEAK and Fn14 were increased in colon samples from CD patients with intestinal obstruction （P〈0.05）. The number of Fn14 and a-SMA positive cells was significantly increased in CD patients with intestinal obstruction （P〈0.05）. Conclusion TWEAK/Fn14 pathway may play an important role in CD related intestinal fibrosis.

关 键 词： 克罗恩病 纤维化