30例原发性皮肤淀粉样变临床表现、治疗及皮损组织病理分析

发布时间：2018-01-22 05:47

本文关键词： 原发性皮肤淀粉样变组织病理免疫组化组织细胞角蛋白　出处：《广西医科大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的探讨原发性皮肤淀粉样变(Primary Cutaneous Amyloidosis, PCA)临床表现、治疗疗效与皮损组织病理学表现的联系,并且检测PCA皮损组织淀粉样物质中CK5的表达及组织细胞表面CD16、CD206的表达情况,对PCA的发病机制作初步探讨。方法采集30例PCA患者的临床资料,设计观察表随访记录患者临床治疗情况；分析30例患者皮损组织病理学表现与临床表现及治疗疗效的关系；通过免疫组化技术检测患者皮损组织中淀粉样物质中CK5的表达情况及组织细胞表面CD16、CD206的表达情况。所得数据用SPSS16.0统计软件进行统计分析。结果原发性皮肤淀粉样变病患者30例,男13人,女17人。其中,苔藓样型(LA)：20例,占66.7%；斑状型(MA)：4例,占13.3%；双型(BA)：5例,占16.7%。异色样型：1例,占3.3%。22例患者伴有瘙痒,8例患者无瘙痒。30例患者皮损组织病理学表现均见表皮组织中散在不同程度的角化不良细胞或坏死的角质形成细胞；伴有瘙痒症状的患者皮损组织1个真皮乳头淀粉样物质中的炎症细胞(组织细胞和淋巴细胞)计数的平均值(30.19±20.88),无瘙痒症状患者的为(14.74±2.73),两者比较有显著差异(P0.05)；炎症细胞浸润重(20个炎症细胞/1个真皮乳头)的患者与炎症细胞浸润轻(20炎症细胞/1个真皮乳头)的患者的治疗前后评分无显著差异(P0.05)。8例患者皮损组织中的淀粉样物质CK5灶状表达；30例患者的皮损组织中组织细胞均未检测到CD206表达。结论 (1)研究结果提示PCA皮损中的淋巴细胞及组织细胞浸润程度与患者的瘙痒程度相关,与疗效无关联。(2)PCA的淀粉样物质的形成可能与角质形成细胞的凋亡、坏死相关联。
[Abstract]:Objective to investigate the clinical manifestations of primary Cutaneous amyloidosissis (PCAs). The relationship between the therapeutic efficacy and histopathological manifestations of lesions, and the expression of CK5 in PCA lesions and the expression of CD16 / CD206 on the surface of tissue cells were detected. Methods the clinical data of 30 patients with PCA were collected and the clinical treatment was recorded by designing an observation table. The relationship between histopathological manifestations, clinical manifestations and therapeutic efficacy of 30 patients with skin lesions was analyzed. Immunohistochemical technique was used to detect the expression of amyloid CK5 and CD16 on the tissue surface. The expression of CD206. The data were analyzed by SPSS16.0 software. Results there were 30 patients with primary cutaneous amyloidosis, 13 males and 17 females. There were 20 cases (66.7%) of mossy type. There were 4 cases (13.3%) of the macular type. There were 5 cases (16.7%) of double type of Bafa, and 1 case of heterochromoid type: 1 case (3.3%), 22 cases with pruritus. The histopathological findings of 8 patients without pruritus and 30 patients with skin lesions showed that keratosis cells or necrotic keratinocytes were scattered in the epidermis to varying degrees. The average count of inflammatory cells (histocytes and lymphocytes) in one dermal papilla amyloid tissue in patients with pruritus was 30.19 卤20.88). The number of patients without pruritus symptom was 14.74 卤2.73g, there was significant difference between the two groups (P 0.05). There was no significant difference in the scores before and after treatment between patients with heavy infiltration of inflammatory cells (20 inflammatory cells / 1 dermal papilla) and patients with mild inflammatory cell infiltration / 1 dermal papilla (P < 0.05). The focal expression of amyloid CK5 in lesions of patients with P0.05 was observed. CD206 expression was not detected in the lesions of 30 patients. The results suggest that the degree of infiltration of lymphocytes and histocytes in the lesions of PCA is related to the degree of pruritus. The formation of amyloid in PCA may be associated with apoptosis and necrosis of keratinocytes.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R758.6

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