CAJ | 학술논문

目的探讨翼状胬肉患者眼表上皮的异常改变及泪膜稳定性.方法回顾性研究.选择2009年11月至2010年2月对15例(15只眼)翼状胬肉患者,观察翼状胬肉切除术前术后泪膜破裂时间(BUT)、基础泪液分泌试验.应用免疫荧光组织化学染色法检测15例翼状胬肉上皮细胞K10、K14、K19、MUC5AC、K16、Ki67和P63蛋白的表达情况,并与正常结膜对照.数据比较采用独立样本t检验.结果正常结膜上皮无表达的K10在翼状胬肉组织中的吸光度(4)值为2017.51±2114.3.翼状胬肉上皮中K19的A值下降至3727.86±2544.73,MUC5AC下降至2080.48 ±2340.17,K14增强至6027.5±1058.32,与正常结膜组织相比,差异均有统计学意义(=9.261,3.538,-6.151;P ＜0.05).增殖指标Ki67、P63和K16的A值分别为881.67 ±517.96、4247.96±2009.38和4455.62±2699.44.翼状胬肉患者术前及术后6个月基础泪液分泌试验结果在常值范围内,泪液BUT平均值为(11.8±4.5)s,较术前的(5.6±2.9)s显著延长(t=-4.222,P ＜0.05).结论翼状胬肉上皮异常分化,以眼表上皮鳞状化生伴随增殖为主,破坏泪膜稳定,从而影响患者眼表功能.
목적 탐토익상노육환자안표상피적이상개변급루막은정성.방법 회고성연구.선택2009년11월지2010년2월대15례(15지안)익상노육환자,관찰익상노육절제술전술후루막파렬시간(BUT)、기출루액분비시험.응용면역형광조직화학염색법검측15례익상노육상피세포K10、K14、K19、MUC5AC、K16、Ki67화P63단백적표체정황,병여정상결막대조.수거비교채용독립양본t검험.결과 정상결막상피무표체적K10재익상노육조직중적흡광도(4)치위2017.51±2114.3.익상노육상피중K19적A치하강지3727.86±2544.73,MUC5AC하강지2080.48 ±2340.17,K14증강지6027.5±1058.32,여정상결막조직상비,차이균유통계학의의(=9.261,3.538,-6.151;P ＜0.05).증식지표Ki67、P63화K16적A치분별위881.67 ±517.96、4247.96±2009.38화4455.62±2699.44.익상노육환자술전급술후6개월기출루액분비시험결과재상치범위내,루액BUT평균치위(11.8±4.5)s,교술전적(5.6±2.9)s현저연장(t=-4.222,P ＜0.05).결론 익상노육상피이상분화,이안표상피린상화생반수증식위주,파배루막은정,종이영향환자안표공능.
Objective To investigate the differentiation and proliferation of the conjunctival epithelium and tear film function in pterygia.Methods It was a retrospective study.Fifteen patients (15 eyes) who underwent excision for pterygium were enrolled in this study.Immunostaining for K10,K14,K19,MUC5AC,K16,Ki67 and P63 was performed on the pterygial epithelium and normal conjunctival epithelium.Schirmer I test was performed,and the tear film break-up time (BUT) was evaluated just prior to and 6 months after surgery.Multi-factor regression analysis was assessed to observe if there is a correlation between pterygial growth and tear film function.Results The average absorbency of K19 and MUC5AC immuno-staining all significantly changed (3727.86 ± 2544.73 vs.25 528.00 ± 12 901.06,2080.48 ±2340.17 vs.7182.51 ±3069.20,t =9.261,3.538,P ＜0.05),and increased in K10 and K14 in patients with pterygia compared with normal conjunctivae keratin (2017.51 ± 2114.3 vs.0,6027.5 ± 1058.32 vs.2123.28 ± 1249.09,t =-6.151,P ＜ 0.05).Furthermore,pterygial epithelium showed activated proliferation,evidenced by significantly up-regulated expression of K16,P63 and Ki67 compared to normal control.The Schirmer I test did not indicate any significant differences pre-and post-operatively.However,the BUT was signficantly prolonged 1 month post surgery compared to pre-surgery (t =-4.222,P ＜ 0.05).Conclusion This study indicates that abnormal epithelial differentiation and proliferation are present in pterygium,which is characterized by squamous metaplasia,accompanied with instability of tear film and normal basic tear secretion.(Chin J Ophthalmol,2013,49:422-427)