PROLIFERATIVE ACTIVITY IN EPIRETINAL MEMBRANES - THE USE OF THE MONOCLONAL-ANTIBODY KI-67 IN PROLIFERATIVE VITREORETINAL DISEASES
PROLIFERATIVE ACTIVITY IN EPIRETINAL MEMBRANES - THE USE OF THE MONOCLONAL-ANTIBODY KI-67 IN PROLIFERATIVE VITREORETINAL DISEASES
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DOI：
10.1097/00006982-199212010-00011
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发表时间：
1992-01-01
影响因子：
3.3
通讯作者：
PETROVSKI, B
中科院分区：
文献类型：
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作者：
HEIDENKUMMER, HP;KAMPIK, A;PETROVSKI, B
视网膜前膜存在于多种不同的疾病中，如增殖性玻璃体视网膜病变(PVR)、增殖性糖尿病视网膜病变(PDR)、黄斑皱褶以及缺血性、炎症性和退行性玻璃体视网膜病变。视网膜前膜的形成以组织发生学上不同类型细胞的增殖为特征。手术切除的视网膜前膜组织的增殖潜能的知识可能在临床上相关，以确定哪些患者面临高复发风险。单抗Ki-67特异性地标记细胞周期相关核抗原，该抗原仅在细胞周期的G1、S和G2/M期的细胞中表达。用这种抗体，通过间接免疫过氧化物酶方法，可以在手术切除的视网膜前膜的冰冻组织样本中染色活跃的增殖生长部分。本研究应用Ki-67单抗对37例PVR、PDR、黄斑皱褶及眼内硅油填塞术后复发的视网膜前膜进行筛查，以确定是否存在活跃的增殖细胞。此外，还定量地确定了一段膜中Ki-67阳性细胞的数量与这段膜的总细胞数的关系。因此，每个膜的增殖指数(PI)被归因于十进制商。增殖指数可分为低或极低(PI<；0.1)、低(PI 0.1~0.3)、中等(Pl 0.3~0.6)和高(PI>；0.6)四个亚组。5个PVR膜中有4个有高增殖活性，14个PDR膜中有9个有高增殖活性，11个硅油填充后复发膜中有6个有高增殖活性，6个黄斑皱褶膜中有2个有高增殖活性。根据这项研究的结果，视网膜前膜内的生长分数似乎有不同程度的激活。这可能是由于眼内环境中存在或缺乏有丝分裂物质所致。通过手术切除的视网膜前膜的增殖指数相对定量测定增殖细胞可能成为增殖性玻璃体视网膜疾病临床分类的有用补充。Ki-67标记指数直接反映了手术时细胞的增殖活性，可能有助于加深对增殖性玻璃体视网膜疾病动力学的了解，为临床试验增加生物学基础。其临床价值还有待长期随访研究证实。
Epiretinal membranes occur in a number of pathogenetically different diseases, such as proliferative vitreoretinopathy (PVR), proliferative diabetic retinopathy (PDR), macular pucker, and ischemic, inflammatory, and degenerative vitreoretinal disorders. The formation of epiretinal membranes is characterized by the proliferation of histogenetically different cell types. Knowledge of the proliferating potential of surgically excised epiretinal membrane tissue might be clinically relevant to determine which patients face a high risk of recurrences. The monoclonal antibody Ki-67 specifically stains a cell-cycle associated nuclear antigen that is only expressed by cells in the G1, S, and G2/M phases of the cell cycle. With this antibody, the actively proliferating growth fraction can be stained in frozen tissue samples of surgically removed epiretinal membranes by the indirect immunoperoxidase method. In this study, the monoclonal antibody Ki-67 was used to screen 37 epiretinal membranes in PVR, PDR, macular pucker, and in recurrences after intraocular silicone oil tamponade for the presence of actively proliferating cells. Additionally, the number of Ki-67 positive cells in a section of the membrane was quantitatively set in relation to the total cell number of this section. Thus a proliferative index (PI) was ascribed to each membrane as a decimal quotient. The proliferative indices can be graded into four subgroups for missing or very low (PI < 0.1), low (PI 0.1-0.3), moderate (Pl 0.3-0.6), and high (PI > 0.6) proliferative activities. High proliferative activities were found in 4 of 5 PVR membranes, in 9 of 14 PDR membranes, in 6 of 11 recurrent membranes after intraocular silicone oil tamponade, and in 2 of 6 macular pucker membranes. According to the results of this study, the growth fraction within epiretinal membranes seems to be activated to various degrees. This might be due to the presence or lack of mitogenic substances within the intraocular environment. The relative quantitative determination of the proliferating cells by a proliferative index of surgically removed epiretinal membranes might become a useful addition to clinical classifications of proliferative vitreoretinal diseases. The Ki-67 labelling index directly reflects the cellular proliferative activity at the time of surgery and might promote more understanding about the dynamics of proliferative vitreoretinal diseases and add a biologic base for clinical trials. Its clinical value still has to be proven by long-term follow-up studies.