角蛋白K14在盘状红斑狼疮与扁平苔癣皮损中的表达及其临床意义

发布时间：2018-06-06 20:45

本文选题：盘状红斑狼疮 + 扁平苔癣　；参考：《广西医科大学》2017年硕士论文

【摘要】：目的初步探讨角蛋白K14在盘状红斑狼疮与扁平苔癣皮损中表达的差异及临床意义。方法选取广西医科大学第一附属医院皮肤科石蜡包埋的盘状红斑狼疮组织20例、扁平苔癣20例为研究对象;以整形美容外科手术后正常皮肤组织10例作为对照,角蛋白K14在扁平苔癣、盘状红斑狼疮、正常人表皮中的表达采用SP免疫组化方法。对表达结果同时采用人工测评半定量法判定,以及Image-Pro Plus 6.0数码医学图像分析系统进行平均光密度定量测定;对两种方法所得结果采用SPSS 17.0软件进行秩和检验和t检验等统计方法,P0.05表示差异有统计学意义。结果1.角蛋白K14在全层表达:正常皮肤组10例在基底层或棘层下部均呈阳性表达,20例DLE组和20例LP组全层均有表达,但DLE组阳性表达主要集中在棘层中部以下,LP组全层表达较均匀,3组间两两比较,均P0.05,差异均有统计学意义。2.角蛋白K14在基底层的表达:20例DLE组中,2例呈弱阳性,余下18例呈阳性表达;LP组、正常皮肤组织中均呈阳性表达,3组间两两比较,均P0.05,差异均无统计学意义。3.角蛋白K14在棘层下部表达:DLE组20例、LP组20例均呈阳性或强阳性表达,而10例正常皮肤组织仅有3例呈阳性表达;阳性表达主要位于角质形成细胞胞浆;实验组与对照组比较,均P0.05,两者间差异有统计学意义;而两实验组相互比较,P0.05,差异无统计学意义。4.角蛋白K14在棘层中部表达:DLE组中2例无表达,余下18例呈阳性或强阳性表达,LP组全部呈强阳性表达,正常皮肤组无表达;阳性表达主要位于角质形成细胞胞浆;3组两两比较,均P0.05,差异有统计学意义。5.角蛋白K14在棘层上部表达:DLE组中6例无表达,余下14例呈强阳性或极强阳性表达;LP组全部呈强阳性或极强阳性表达,正常皮肤组无表达;阳性表达主要位于角质形成细胞胞浆;3组两两比较,均P0.05,差异有统计学意义。结论1.角蛋白K14在LP和DLE组表达增强,提示角蛋白K14可能在一定程度上参与两者的发生发展。2.角蛋白K14在LP和DLE组棘层中部及棘层上部表达存在差异,提示其在两者角质形成细胞后期的增殖及分化中的调控作用可能存在差异,确切机制有待进一步研究。3.LP组较DLE组角蛋白K14表达更强,尤其是在棘层上部呈相对强阳性表达时,有可能成为两者鉴别诊断的有用参考指标。
[Abstract]:Objective to investigate the difference and clinical significance of keratin K 14 expression in the lesions of lupus platensis and lichen planus. Methods Twenty cases of discoid lupus erythematosus and 20 cases of lichen planus were selected from dermatology department of the first affiliated Hospital of Guangxi Medical University, and 10 cases of normal skin tissue after plastic surgery were used as control. The expression of keratin K14 in the epidermis of lichen planus, discoid lupus erythematosus and normal human epidermis was detected by SP immunohistochemical method. At the same time, the expression results were determined by artificial semi-quantitative method and by Image-Pro Plus 6.0 digital medical image analysis system for quantitative measurement of average optical density. There was significant difference between the two methods by using SPSS 17.0 software for rank sum test and t test. Result 1. The expression of keratin K14 in the whole layer: the positive expression of keratin K14 was found in 10 cases of normal skin group and 20 cases of DLE group and 20 cases of LP group. But the positive expression of DLE group was mainly concentrated in the whole layer of LP group below the middle part of spinous layer, which was more uniform than that of the control group (P0.05), and the difference was statistically significant (P < 0.05). The expression of keratin K14 in the basal layer of 20 cases of DLE was weakly positive in 2 cases, and in the other 18 cases of positive expression in LP group. The positive expression of keratin K14 in normal skin tissue was significantly higher than that in control group (P0.05, P 0.05), and there was no significant difference between the three groups (P < 0.05). The expression of keratin K14 was positive or strongly positive in 20 cases of LP group and only 3 cases of normal skin tissue in 10 cases, the positive expression was mainly located in cytoplasm of keratinocytes, and the positive expression of keratin K14 was mainly in cytoplasm of keratinocytes in the control group, compared with the control group, the positive expression of keratin K14 was found in the cytoplasm of keratinocytes. The difference between the two groups was statistically significant, while there was no significant difference between the two experimental groups. Keratin K14 was expressed in the middle of the spinous layer in 2 cases without expression, the remaining 18 cases showed strong positive expression in LP group and normal skin group, and the positive expression was mainly in cytoplasmic cytoplasm of keratinocytes. The difference was statistically significant. There was no expression of keratin K14 in the upper part of the spinous layer in 6 cases, while in the other 14 cases, it was strongly positive or very strong positive in LP group, and no expression was found in normal skin group. The positive expression was mainly located in cytoplasm of keratinocytes (P 0.05). Conclusion 1. The expression of keratin K14 was enhanced in LP and DLE groups, suggesting that keratin K14 might be involved in the occurrence and development of keratin K14 to some extent. There were differences in the expression of keratin K14 between LP and DLE groups in the middle and upper part of the spinous layer, which suggested that K14 might play a different role in the proliferation and differentiation of keratinocytes. The exact mechanism of keratin K14 expression in LP group is higher than that in DLE group, especially in the upper part of spinous layer, which may be a useful reference index for differential diagnosis.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R758.6

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