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目的 了解细胞凋亡相关蛋白Fas,FasL和Bcl 2的表达在自身免疫性甲状腺疾病发病机制及病理变化中的作用及意义。方法 采用免疫组织化学方法 ,检测 2 0例桥本甲状腺炎、2 0例Graves病及 2 0例甲状腺腺瘤 (对照组 )患者甲状腺标本中Fas,FasL和Bcl 2的表达及分布。结果 Fas在所有的标本中表达 ,主要分布于甲状腺滤泡细胞的表面和细胞质上。除了 3例甲状腺瘤标本外 ,其余的都有FasL表达。Bcl 2表达于 15例桥本甲状腺炎 ,19例Graves病以及 17例甲状腺瘤的甲状腺滤泡细胞上。在甲状腺瘤的滤泡细胞上表达中等强度的Fas,很少或是没有表达FasL。在桥本甲状腺炎中Fas和FasL免疫染色强阳性甲状腺滤泡细胞多分布于浸润淋巴滤泡附近 ,浸润淋巴细胞中Fas ,FasL免疫染色相对较弱。在Graves病中 ,Fas的表达强度与桥本甲状腺炎类似 ,但是FasL的表达却更弱。在Graves病和甲状腺瘤组织中 ,Bcl 2的表达两者类似。但在桥本甲状腺炎组织中 ,分布于浸润淋巴细胞附近的甲状腺滤泡细胞以及生发中心的淋巴细胞上 ,Bcl 2的表达很弱。结论 Fas,FasL和Bcl 2的表达在桥本甲状腺炎和Graves病中相似。FasL的高表达和Bcl 2的低表达可能引起桥本甲状腺炎滤泡细胞的凋亡。进一步证明了这三种细胞凋亡因子在自身免疫性甲状腺疾病发病机制?
Objective To investigate the role and significance of the expression of apoptosis-related proteins Fas, FasL and Bcl 2 in the pathogenesis and pathological changes of autoimmune thyroid diseases. Methods Immunohistochemical method was used to detect the expression and distribution of Fas, FasL and Bcl 2 in thyroid specimens from 20 patients with Hashimoto’s thyroiditis, 20 Graves’ disease and 20 thyroid adenomas (control group). Results Fas was expressed in all samples, mainly distributed on the surface of thyroid follicular cells and cytoplasm. In addition to three cases of thyroid tumor specimens, the rest have FasL expression. Bcl 2 was expressed on thyroid follicular cells in 15 cases of Hashimoto’s thyroiditis, 19 cases of Graves’ disease and 17 cases of thyroid tumors. Moderate-intensity Fas is expressed on thyroid tumor follicular cells with little or no FasL expression. In Hashimoto’s thyroiditis, Fas and FasL immunostaining strongly positive thyroid follicular cells distributed in the vicinity of infiltrative lymphoid follicles, infiltrating lymphocytes Fas, FasL immunostaining is relatively weak. In Graves disease, the expression of Fas is similar to that of Hashimoto’s thyroiditis, but the expression of FasL is even weaker. Bcl2 expression is similar in both Graves disease and thyroid tumors. However, in Hashimoto’s thyroiditis tissues, the expression of Bcl 2 is weak on thyroid follicular cells and lymphocytes that are located in the germinal center near the infiltrating lymphocytes. Conclusion The expressions of Fas, FasL and Bcl 2 are similar in Hashimoto’s thyroiditis and Graves disease. High expression of FasL and low expression of Bcl 2 may cause apoptosis in Hashimoto’s thyroiditis follicular cells. Further evidence of these three apoptotic factors in the pathogenesis of autoimmune thyroid disease?