Abstract
Aim: To estimate the deepness, intensity and reversibility of structural changes in bronchial walls in III-IV COPD stg with immunomorphological method using.
Study disign: 42 pts (mean age 59±1.7 years) with COPD: I gr.- 30 pts with III stg (20 male), II gr.- 12 pts with IV stg (9 male). Bronchoscopy with consequent histology sampling and assessing by microscopy and immunohistochemistry (IHC) research was done for all pts. The following indexes were evaluated: Ki-67 (reflect proliferative potential and activity of epithelial regeneration); Cytokeratins 8 (Ctk) (as a marker of glandular epithelium); Ctk 34βE12 (squamous epithelium origin).
Results:
In Gr I all pts had been demonstrated intensive positive membrane reactions with Ctk 8 in uninjurious ciliary's and basal epithelial cells and heterogeneous positive membrane reactions with Ctk 34βE12. The simultaneous co-expression of both types of cytokeratins indicates the reversibility of metaplasia.Histological investigation: hypertrophy of smooth muscles, polipoid overgrowthing of mucous, proliferation of fibroblasts.
In Gr II took place focal positive membrane reaction with Ctk 8 in residual glandular cells, and intensive expression of Ctk 34βE12 without co-expression of both markers.
Conclusion: 1. Pts with COPD III had been estimated changes with high reversibility, but with provided exclusion trigger agents and relevant therapy, in comparison with COPD, stage IV. 2. Pts with COPD, stage IV, the atrophy and sclerosis predominated. Immunomorphological data indicates about regenerative depletion and permanent irreversible changes of bronchial tree.
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