CAJ | 학술논문

目的了解病理性瘢痕表皮组织中TGF-βⅡ型受体(TβRⅡ)的基因表达.方法 20份病理性瘢痕标本收集于2007 -2009年济南军区总医院收治的20例烧伤或外伤瘢痕患者,于每份瘢痕标本中央和边缘部位分别切取1块表皮组织.每例患者留取1块距离病变部位10 cm以上的正常皮肤组织标本作为自身对照1.抽取每例患者1 ～2 mL全血并分离提取血清,作为自身对照2.另取8例无病理性瘢痕病史患者术中弃用的8份正常皮肤组织标本作为正常对照.生物素-链霉亲和素-过氧化物酶染色法检测3种组织标本中TβRⅡ的阳性表达.经PCR-单链构象多态性分析、基因测序,对比观察各标本中TβRⅡ的基因表达.对数据行Fisher确切概率法检验.结果免疫组织化学染色结果显示,病理性瘢痕表皮组织标本中TβRⅡ阳性表达明显低于自身对照1和正常对照组织标本,主要位于表皮的基底层,而棘层、颗粒层和角质层中TβRⅡ阳性表达很少或缺失.在自身对照1、自身对照2和正常对照标本中未见TβRⅡ基因异常表达;在8份病理性瘢痕表皮组织标本中,TβRⅡ多聚A位点的片段出现条带泳动异常,基因测序显示DNA片段缺失1个A(P=0.044).结论病理性瘢痕表皮组织中可能存在TβRⅡ基因的异常表达.瘢痕表皮回植可能会增加病理性瘢痕复发的风险,而切取瘢痕患者正常皮肤植皮修复创面可能不会增加瘢痕复发的风险.
목적 료해병이성반흔표피조직중TGF-βⅡ형수체(TβRⅡ)적기인표체.방법 20빈병이성반흔표본수집우2007 -2009년제남군구총의원수치적20례소상혹외상반흔환자,우매빈반흔표본중앙화변연부위분별절취1괴표피조직.매례환자류취1괴거리병변부위10 cm이상적정상피부조직표본작위자신대조1.추취매례환자1 ～2 mL전혈병분리제취혈청,작위자신대조2.령취8례무병이성반흔병사환자술중기용적8빈정상피부조직표본작위정상대조.생물소-련매친화소-과양화물매염색법검측3충조직표본중TβRⅡ적양성표체.경PCR-단련구상다태성분석、기인측서,대비관찰각표본중TβRⅡ적기인표체.대수거행Fisher학절개솔법검험.결과 면역조직화학염색결과현시,병이성반흔표피조직표본중TβRⅡ양성표체명현저우자신대조1화정상대조조직표본,주요위우표피적기저층,이극층、과립층화각질층중TβRⅡ양성표체흔소혹결실.재자신대조1、자신대조2화정상대조표본중미견TβRⅡ기인이상표체;재8빈병이성반흔표피조직표본중,TβRⅡ다취A위점적편단출현조대영동이상,기인측서현시DNA편단결실1개A(P=0.044).결론 병이성반흔표피조직중가능존재TβRⅡ기인적이상표체.반흔표피회식가능회증가병이성반흔복발적풍험,이절취반흔환자정상피부식피수복창면가능불회증가반흔복발적풍험.
Objective To study the gene expression of transforming growth factor β receptor Ⅱ (TβR Ⅱ ) in pathological scar. Methods Twenty samples of pathological scar were collected from 20 burn or trauma patients hospitalized in the General Hospital of Ji'nan Military Command from 2007 to 2009.Twenty specimens of epidermal layer were obtained from the middle portion and the edge of pathological scars.Twenty normal skin specimens which were located more than 10 cm away from the lesion sites of 20patients were collected as self-controls.Serum from 1-2 mL whole blood were obtained from each of the 20 patients for second self-control.Eight normal skin specimens from 8 patients without pathological scar,discarded from un-related operations,were also collected as negative-control.Positive expressions of TβR Ⅱ in three different skin specimens were determined with biotin-streptavidin-peroxidase staining.Gene expressions of TβR Ⅱ in all specimens were compared with PCR-single strand conformation polymorphism analysis and gene sequencing.Data were processed with Fisher's exact test. Results Positive expression of TβRⅡ in pathological scar epidermis was lower than that in normal skin specimen of patients with pathological scar or normal skin specimen of patients without pathological scar,and TβR Ⅱ was mainly located in the basal layer of epidermis.Positive expressions of TβR Ⅱ were seldom found in acanthocytes,granular cells,and cuticle or even non-existing.No abnormality of TβR Ⅱ was found in normal skin epidermis or serum samples of pathological scar patients or normal skin epidermis of patients without pathological scar.TβR Ⅱ expressing in 8 specimens of epidermis of pathological scar showed abnormal electrophoresis pattern at poly A fragments band and loss of one A base in DNA fragment ( P =0.044 ). Conclusions There may be abnormal gene expression of TβR Ⅱ in pathological scar epidermis.Replantation of epidermis of scar may increase the risk of scar recurrence,while replantation of normal skin of patients with scar on wound may not increase the risk of scar recurrence.