This journal is
indexed in Scopus
Year 2016 Vol. 24 No 1
GENERAL & SPECIAL SURGERY
I.A. KRYVORUCHKO, N.Ì. GONCHAROVA, I.A. TARABAN, I.V. SOROKINA
THE FEATURES OF MORPHOGENESIS OF COMPLICATED PANCREATIC PSEUDOCYSTS
Kharkov National Medical University of the Ministry of Public health Ukraine
Objectives. To study the specific wall structural features of complicated pancreatic pseudocyst and pancreatic pseudocysts located within the pancreatic parenchyma by immunohistochemical techniques.
Methods. The features of pseudocyst morphogenesis using immunohistochemical methods have been studied in biopsies of patients (n=47) with complicated pancreatic pseudocysts.
Results. The predominance of type III collagen and the deficiency of type I collagen in the walls of type I pseudocysts and adjacent pancreatic parenchyma in the connective tissue component have been revealed; in the vascular component – deficiency of type IV collagen and weak capacity of endothelial cells to express receptors for endothelin-1. Predominance CD18 in the inflammatory infiltrates testified to favour of an acute inflammatory reaction with a marked tendency to fester. The ability of cellular pancreatic component to express receptors to HLADR–antigen was low. In the connective tissue component of pseudocysts type II the both types of collagens with a predominance of type III collagen over type I collagen have been identified.The microvessel walls of pseudocysts type II were presented by the basal membranes, containing type IV collagen and endotheliocytes located on the surface were able to express receptors for endothelin–1; lymphocytes CD3 and CD20 were dominated. The degree of receptor expression to HLADR–antigen was low. The predominance of type I collagen over type III collagen was considered to be the feature of pseudocysts type III. Basal membranes of microvessel walls of type III pseudocysts were thickened due to excessive accumulation of type IV collagen, leading to the reduced ability of the endothelial lining to express receptors for endothelin–1.
Conclusion. The appearance of type I collagen in the walls of pseudocysts type II is binded with maturation phase – type I collagen replaces type III, indicating a chronic process, i.e. as maturation continues pseudocyst type II developed in the connective tissue wall of pseudocysts type I. The high degree of expression of HLA DR-antigen indicated to the presence of an autoimmune link in the morphogenesis of type III pseudocysts.
- Apte M, Pirola R, Wilson J. The fibrosis of chronic pancreatitis: new insights into the role of pancreatic stellate cells. Antioxid Redox Signal. 2011 Nov 15;15(10):2711-22. doi: 10.1089/ars.2011.4079.
- Nichitailo ME, Kravchenko DA, Shpon'ka IS, Medvetskii EB, Savitskaia IM, Bulik II, i dr. Ingibirovanie zvezdchatykh kletok podzheludochnoi zhelezy lizinoprilom i lovastatinom dlia preduprezhdeniia fibroza ee kul'ti posle distal'noi rezektsii v modeli khronicheskogo alkogol'nogo pankreatita [Inhibition of stellate cells of the pancreas by lisinopril and lovastatin to prevent fibrosis after it stump after distal resection in a model of chronic alcoholic pancreatitis]. Kl³n Kh³rurg³ia. 2013;(2):65-66.
- Zaporozhchenko BS, Shevchenko VG. Immunologicheskaia reaktivnost' u bol'nykh psevdokistami podzheludochnoi zhelezy v razlichnykh usloviiakh khirurgicheskogo lecheniia [Immunological reactivity in patients with pancreatic pseudocysts in different surgical conditions]. Khark³' Kh³rurg Shk. 2012;(2):45-47.
- Krivoruchko IA, Teslenko SM, Teslenko MM, Cheverda VM, AndreЄshchev SA. Rol' marker³v poshkodzhennia endotel³iu v prognozuvann³ gostrogo p³sliaoperats³inogo pankreatitu p³slia priamikh vtruchan' na p³dshlunkov³i zaloz³ z perevazhnikh urazhenniam ¿¿ golovki [The role of endothelial damage markers in predicting postoperative acute pancreatitis after direct interventions on the pancreas, mainly affecting her head]. Kl³n Kh³rurg³ia. 2014;(9.2):25-28.
- Shevchenko BF, Bab³i OM, Tatarchuk OM, Kudriavtseva VЄ. Viznachennia aktivnost³ zapal'nogo protsesu v p³dshlunkov³i zaloz³ pri khron³chnomu pankreatit³ [Determination of inflammation in the pancreas in chronic pancreatitis]. Kl³n Kh³rurg³ia. 2014;(7):10-13.
- Doroshkevich SV, Pivchenko PG, Doroshkevich EIu. Patogeneticheskie mekhanizmy formirovaniia psevdokist podzheludochnoi zhelezy v eksperimente [The pathogenetic mechanisms of pancreatic pseudocysts in the experiment]. Novosti Khirurgii. 2009;17(2):8-13.
- Kade AKh, Zanin SA, Gubareva EA, Turovaia AIu, Bogdanova IuA, Apsaliamova SO. Fiziologicheskie funktsii sosudistogo endoteliia [The physiological function of the vascular endothelium]. Fundam Issledovaniia. 2011;(11):611-17.
- D'Egidio A, Schein M. Pancreatic pseudocysts: a proposed classification and its management implications. Br J Surg. 1991 Aug;78(8):981-4.
- Gubina-Vakulik GI, Sorokina IV, Markovskii VD, Kupriianova L S, Sidorenko RV. Spos³b k³l'k³snogo viznachennia vm³stu antigenu v b³olog³chnikh tkaninakh [The method of quantitative determination of the antigen content in biological tissues.]. Patent Ukrainy ¹46489 G01N 33/00. 25.12.2009.
- Liliensiek SJ, Nealey P, Murphy CJ. Characterization of endothelial basement membrane nanotopography in rhesus macaque as a guide for vessel tissue engineering. Tissue Eng Part A. 2009 Sep;15(9):2643-51. doi: 10.1089/ten.TEA.2008.0284.
- Arias JI, Aller MA, Arias J. Surgical inflammation: a pathophysiological rainbow. J Transl Med. 2009; 7: 19. doi: 10.1186/1479-5876-7-19.
- Shankarkumar U. The Human Leukocyte Antigen (HLA) System. Int J Hum Genet. 2004;4(2): 91-103.
- Reis AB, Morozov SV, Poluektov VL, Reis B.A, V. A. Samoilov, N. S. Degtiareva, i dr. Novye tekhnologii v diagnostike i operativnom lechenii postnekroticheskikh oslozhnenii ostrogo pankreatita [New technologies in the diagnosis and surgical treatment of acute postnecrotic pancreatitis complications]. Omskii Nauch Vestn. 2013;(1):156-59.
- Okazaki K. Autoimmune pancreatitis: etiology, pathogenesis, clinical findings and treatment. The Japanese experience. JOP. 2005 Jan 13;6(1 Suppl):89-96.
61022, Ukraine, Harkov, pr. Lenina, d. 4,
Harkovskiy natsionalnyiy meditsinskiy universitet,
kafedra khirurgii ¹ 2,
tel. office. 38 050 301-90-90,
Kryvoruchko Igor Andreevich
Kryvoruchko I.A. MD, professor, a head of the surgery chair ¹ 2 of Kharkov National Medical University.
Goncharova N.M. PhD, an applicant for Doctor’s degree of the surgery chair ¹ 2 of Kharkov National Medical University.
Taraban I.A. MD, professor of the surgery chair ¹ 2 of Kharkov National Medical University.
Sorokina I.V. MD, professor of the pathologic anatomy chair of Kharkov National Medical University.