CAJ | 학술논문

目的了解皮肤软组织扩张术后表皮干细胞(ESC)的分化和分布情况,初步探讨扩张皮肤组织的相关生长机制. 方法取15例行Ⅱ期头、颈部皮肤扩张术患者扩张后(平均注水期45d)皮肤标本及正常皮肤标本,按取材部位分为:(1)头部近扩张器中心组:取与扩张器中轴线垂直距离为3cm处的扩张后头皮;(2)头部扩张器侧壁组:取与扩张器中轴线垂直距离为5～7 cm的扩张后头皮;(3)颈部扩张皮肤组;(4)未扩张头皮对照组;(5)未扩张颈部皮肤对照组.各组皮肤标本行HE染色观察组织结构,行免疫组织化学染色观察细胞角蛋白19(CK19)阳性细胞的分化及分布特征. 结果与2个末扩张对照组比较,HE染色可见各扩张组表皮层凹凸不平且相对增厚,皱褶明显,细胞层次增多;细胞呈密集分布,以靠近基底层最为显著,但排列欠整齐,极性过度不明显.免疫组织化学染色显示,各扩张组基底层CK19阳性细胞的连续性基本存在,基底层个别部位阳性细胞明显增多,呈复层排列;基底层之外亦有少量成团或散在分布的CK19阳性细胞.2个未扩张对照组未见上述现象. 结论 J 皮肤软组织扩张后,ESC 在修复过程中增殖和分化加强,并出现异化分布.
목적 료해피부연조직확장술후표피간세포(ESC)적분화화분포정황,초보탐토확장피부조직적상관생장궤제. 방법 취15례행Ⅱ기두、경부피부확장술환자확장후(평균주수기45d)피부표본급정상피부표본,안취재부위분위:(1)두부근확장기중심조:취여확장기중축선수직거리위3cm처적확장후두피;(2)두부확장기측벽조:취여확장기중축선수직거리위5～7 cm적확장후두피;(3)경부확장피부조;(4)미확장두피대조조;(5)미확장경부피부대조조.각조피부표본행HE염색관찰조직결구,행면역조직화학염색관찰세포각단백19(CK19)양성세포적분화급분포특정. 결과 여2개말확장대조조비교,HE염색가견각확장조표피층요철불평차상대증후,추습명현,세포층차증다;세포정밀집분포,이고근기저층최위현저,단배렬흠정제,겁성과도불명현.면역조직화학염색현시,각확장조기저층CK19양성세포적련속성기본존재,기저층개별부위양성세포명현증다,정복층배렬;기저층지외역유소량성단혹산재분포적CK19양성세포.2개미확장대조조미견상술현상. 결론 J 피부연조직확장후,ESC 재수복과정중증식화분화가강,병출현이화분포.
Objective To observe the differentiation and distribution of epidermal stem cell(ESC) after skin soft tissue expansion.and to initially probe into the growth mechanism of expanded skin tissue.Methods Samples of normal skin and expanded skin(mean affusion period 45 days)were harvested from head and cervical region in 15 patients who underwent II stage surgery after skin expansion.Samples were divided into scalp adjacent to the center of expander group(expanded scalp,3 cm from the vertical axis of the expander),scalp from lateral part of the expander group(expanded scalp,5-7 cm lateral to the vertical axis of the expander),cervical skin expansion group,un-expanded scalp control group,and an-expanded cervical skin control group.according to the position of skin harvested.The tissue structure of skin in each group was observed with HE staining,and the differentiation and distribution characteristics of cytokeratin 19 (CK19)positive cells were observed with immunohistochemical staining. Results Compared with those in the un-exDanded control groups,uneven,relatively thickened and obviously folded epidermis with more cell lavers and cells with obvious aggregation close to the basal layer were observed in the expanded groups,hut those cells were not well-arranged and the transition of polarity was not obvious.The continuity of CK19 positive cells in the basal layer of skin was observed in each of the expanded group with immunohistochemical staining.and positive cells increased obviously and arranged in muhilayer in certain parts of basal layer.CIustered or dispersed CK19 positive cells were also observed outside the basal layer.No above-mentioned ohenomenon was observed in the un-expanded control group. Conclusions The proliferation and differen- tiation of ESC with eetopic distribution may enhance the repair process after skin soft tissue expansion.