■良性气道狭窄(BAS),即各种良性病变引起的气道狭窄,会导致不同程度的呼吸困难,甚至因窒息而死亡。本研究旨在阐明BAS的临床特点,包括病因,治疗和病理学,通过分析BAS患者的临床资料。
■使用2017年1月至2022年12月的617例BAS病例的临床资料进行回顾性分析。通过苏木精-伊红(H&E)和Masson's染色评估组织的病理学特征。此外,通过免疫组织化学(IHC)测定蛋白质表达水平。
■共纳入617名患者(333名女性[53.97%]和284名男性[46.03%]),平均年龄48.93±18.30(范围14-87)。结核病(n=306,49.59%)和创伤(n=179,29.02%)是BAS的两个主要病因,其次是气道异物(FB,n=74,11.99%),外部压缩(n=25,4.05%)和其他病因(n=33,5.35%)。在306例结核性气管支气管狭窄(TBTS)中,大多数是女性(n=215,70.26%),TBTS主要发生在左主支气管(n=97,31.70%),其次是右中支气管(n=70例,22.88%)。大多数TBTS患者(n=259,占84.64%)接受了介入治疗。179名BAS患者的病情归因于创伤,如气管插管(n=92,51.40%),气管切开术(n=69,38.56%),损伤(n=15,8.38%)和手术(n=3,1.68%),主要发生在气管(n=173,96.65%)。TAS患者主要接受介入治疗(n=168,93.85%)和支架植入术(n=47,26.26%)。BAS的肉芽组织主要表现为炎症,增殖和纤维化。免疫组化显示转化生长因子-β1(TGF-β1)表达上调,α-平滑肌肌动蛋白(α-SMA),I型胶原蛋白(COL-I)和波形蛋白,以及E-cadherin的表达下调,这表明纤维化和上皮间质转化(EMT)。
■结核病是主要病因,创伤是次要病因。BAS的肉芽组织以炎症为特征,纤维化和可能的EMT。综合介入治疗是治疗BAS的有效方法。
UNASSIGNED: Benign airway stenosis (BAS), namely airway narrowing caused by a variety of benign lesions, can lead to varying degrees of breathing difficulties and even death due to asphyxia. This study aimed to elucidate the clinical characteristics of BAS, including etiology, treatment and pathology, by analyzing the clinical data of BAS patients.
UNASSIGNED: A retrospective analysis was conducted using the clinical data of 617 BAS cases from January 2017 to December 2022. The pathological characteristics of the tissues were assessed by hematoxylin-eosin (H&E) and Masson\'s staining. Besides, protein expression levels were determined by immunohistochemistry (IHC).
UNASSIGNED: A total of 617 patients were included (333 females [53.97%] and 284 males [46.03%]), with an average age of 48.93 ± 18.30 (range 14-87). Tuberculosis (n = 306, 49.59%) and trauma (n = 179, 29.02%) were the two leading etiologies of BAS, followed by airway foreign bodies (FB, n = 74, 11.99%), external compression (n = 25, 4.05%) and other etiologies (n = 33, 5.35%). Among 306 tuberculous tracheobronchial stenosis (TBTS) cases, most were females (n = 215, 70.26%), and TBTS mainly occurred in the left main bronchus (n = 97, 31.70%), followed by the right middle bronchus (n = 70 cases, 22.88%). The majority of TBTS patients (n = 259, 84.64%) were treated by interventional therapy. The condition of 179 BAS patients was ascribed to trauma, such as tracheal intubation (n = 92, 51.40%), tracheotomy (n = 69, 38.56%), injury (n = 15, 8.38%) and surgery (n = 3, 1.68%), which mostly took place in the trachea (n = 173, 96.65%). TAS patients mainly received interventional therapy (n = 168, 93.85%) and stent implantation (n = 47, 26.26%). The granulation tissues of BAS primarily featured inflammation, proliferation and fibrosis. IHC indicated the up-regulated expressions of transforming growth factor-β1 (TGF-β1), α-smooth muscle actin (α-SMA), collagen type I protein (COL-I) and vimentin, and the down-regulated expression of E-cadherin, which indicated fibrosis and epithelial-mesenchymal transition (EMT).
UNASSIGNED: Tuberculosis was the main etiology, and trauma was the secondary etiology. The granulation tissues of BAS were characterized by inflammation, fibrosis and probably EMT. Comprehensive interventional therapy is an effective method of treating BAS.