CAJ | 학술논문

目的探讨负压吸疱和切削取皮对移植表皮角质形成细胞生理状态的影响.方法免疫组化法检测32例稳定期白癜风患者两种取皮法获得的自体表皮PCNA和Caspase-3的表达情况.结果 32例白癜风患者两种方法所取正常表皮组织皆有不同程度的PCNA表达,发疱所获表皮阳性细胞多灶状分布于基底层,切削所取表皮少数阳性细胞还见于棘层中下部,切削取皮与发疱取皮总的阳性表达率比较差异有统计学意义(x2=10.99,P<0.05),切削取皮与正常人对照比较差异无统计学意义(x2=1.31,P>0.05),而发疱取皮与正常人对照的表达差异有统计学意义(x2=14.08,P<0.05).32例白癜风患者两种方法所取皮肤组织切片皆见Caspase-3表达,主要见于基底层及棘层中下部的角质形成细胞的胞质,两两比较发现患者切削取皮、发疱取皮与正常人对照组总的阳性表达率差异无统计学意义(x2=1.41、2.89、1.91,P>0.05).结论表皮细胞增殖功能对移植表皮的成活可能有重要的作用,切削取皮较吸疱取皮对角质形成细胞的增殖功能影响小.
목적 탐토부압흡포화절삭취피대이식표피각질형성세포생리상태적영향.방법 면역조화법검측32례은정기백전풍환자량충취피법획득적자체표피PCNA화Caspase-3적표체정황.결과 32례백전풍환자량충방법소취정상표피조직개유불동정도적PCNA표체,발포소획표피양성세포다조상분포우기저층,절삭소취표피소수양성세포환견우극층중하부,절삭취피여발포취피총적양성표체솔비교차이유통계학의의(x2=10.99,P<0.05),절삭취피여정상인대조비교차이무통계학의의(x2=1.31,P>0.05),이발포취피여정상인대조적표체차이유통계학의의(x2=14.08,P<0.05).32례백전풍환자량충방법소취피부조직절편개견Caspase-3표체,주요견우기저층급극층중하부적각질형성세포적포질,량량비교발현환자절삭취피、발포취피여정상인대조조총적양성표체솔차이무통계학의의(x2=1.41、2.89、1.91,P>0.05).결론 표피세포증식공능대이식표피적성활가능유중요적작용,절삭취피교흡포취피대각질형성세포적증식공능영향소.
Objective To compare the effects of two skin sampling methods (negative pressure suction blister and skin shaving) on the physical status of autologous epidermal keratinocytes transplanted to patients with vitiligo. Methods Skin samples were obtained from the normal skin of 32 patients with stable vitiligo by suction blister under negative pressure and skin shaving alone or in combination. Immunohistochemistry was performed to examine the expression of proliferating cell nuclear antigen (PCNA) and caspase-3 in these samples.Skin tissues resected from 15 normal human subjects served as the control. Results There was an expression of PCNA and caspase-3 at different degrees in all the skin tissues obtained by the two sampling methods from the 32 patients. Most PCNA-positive cells were focally distributed at the basal layer in epidermis obtained from suction blisters, and a few PCNA-positive cells were observed in the middle and lower part of the prickle cell layer of epidermis from shaved skin. There was a significant difference in the percentage of PCNA-positive cells between the epidermis from suction blisters and shaved skin as well as between the epidermis from suction blisters and normal control skin (x2 = 10.99, 14.08, both P < 0.05), but not between the epidermis from shaved skin and normal control skin (x2 = 1.31, P > 0.05). The expression of caspase-3 was predominantly located in the cytoplasm of keratinocytes in the basal layer as well as middle and lower part of prick cell layer, and no difference was observed in the percentage of caspase-3-expressing keratinocytes between the epidermis from shaved skin, suction blisters and normal control skin (x2 = 1.41, 2.89, 1.91, all P > 0.05). Conclusions The proliferation activity of epidermal cells seems important to the survival of grafted skin, and compared to the suction blister technique, skin shaving appears to have less influence on the proliferation of keratinocytes.