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目的 :研究中耳胆脂瘤上皮细胞增生和凋亡的状态。方法 :应用免疫组化染色 SABC技术及原位凋亡细胞标记技术 (TU NEL 法 ) ,对 2 0例中耳胆脂瘤上皮组织和 10例外耳道正常上皮组织样本进行研究。结果 :在中耳胆脂瘤上皮中 ,增殖细胞核抗原 (PCNA )阳性细胞大量存在于基底细胞层、棘细胞层及颗粒细胞层 ,而在正常外耳道上皮中 PCNA阳性细胞仅存在于基底层 ;在胆脂瘤上皮中 PCNA阳性细胞率和平均光密度分别为(36 .91± 2 2 .77) %和 0 .2 4 2 7± 0 .0 5 86 ,明显高于正常外耳道上皮中的 PCNA阳性细胞率 (10 .2 5± 2 .6 5 ) %及平均光密度 (0 .1340± 0 .0 36 3) ,其差异有显著性意义 (P<0 .0 5 )。同时 ,在胆脂瘤上皮中 ,凋亡细胞存在于棘细胞层及颗粒细胞层 ,而外耳道正常上皮与之相似 ,但两者的凋亡率分别为 (2 7.5 0± 12 .5 0 ) %和 (9.96± 3.86 ) % ,其差异有显著性意义 (P <0 .0 5 )。结论 :中耳胆脂瘤上皮具有高度增生和凋亡的能力 ,并因上皮细胞的增生、分化、凋亡导致角化碎片累积而形成胆脂瘤
Objective: To investigate the status of epithelial cell proliferation and apoptosis in middle ear cholesteatoma. Methods: Twenty-one cases of middle ear cholesteatoma epithelial tissue and 10 cases of normal auditory canal epithelial tissue samples were studied by immunohistochemical SABC technique and TUNEL method. Results: In the middle ear cholesteatoma epithelium, PCNA positive cells were abundant in the basal cell layer, the spine cell layer and the granulosa cell layer, while PCNA positive cells existed only in the basal layer in the normal external auditory canal epithelium. The PCNA positive cell rate and average optical density in cholesteatoma epithelium were (36.91 ± 2.27)% and 0.2247 ± 0.056, respectively, which were significantly higher than those in normal external auditory canal epithelium Cell ratio (10.25 ± 2.56)% and average optical density (0.1340 ± 0.366), the difference was significant (P <0.05). In the meantime, in the cholesteatoma epithelium, apoptotic cells were present in the spine and granulosa layers, while the normal epithelium of the external auditory meatus was similar, but the apoptotic rates were (2 7.5 0 ± 12.5)% And (9.96 ± 3.86)%, the difference was significant (P <0.05). Conclusion: The middle ear cholesteatoma epithelium has a high degree of proliferation and apoptosis, and due to epithelial cell proliferation, differentiation, apoptosis led to the accumulation of keratosis fragments to form cholesteatoma