肥大细胞在增生性瘢痕组织中的分布特征及其意义

Distribution and significance of mast cell in hypertrophic scar tissue

目的:探讨肥大细胞(MC)在增生性瘢痕(HS)组织中的分布特征及其促纤维化作用。方法:结合MC 超微结构改变,采用甲苯胺蓝和 MC 类胰蛋白酶(MCT)免疫组织化学染色方法,观察67例面颈部烧伤后 HS患者皮肤标本和10例正常人皮肤标本,比较 MC 分布特征与病理性胶原结构形成的关系。结果:在早期瘢痕(≤6个月)组织中可见胞体肥大和 MCT 阳性颗粒丰富的 MC,其周围基质内也有 MCT 阳性物质分布,超微结构显示颗粒内容物丰富的 MC 与 FB 之间密切接触,可见胞膜融合和颗粒转移相;随着瘢痕增生和成熟,MC 密度显著下降(P<0.05～0.001),其胞膜突起和颗粒内容物明显减少,大多分布于胶原纤维间和胶原结节的边缘。结论:MC 动态分布特征和活跃的生物学行为显示其参与了 HS 胶原结构的形成。

Objective:To investigate the distribution characteristic of the mast cell(MC)and its effect on fibrosis in hypertrophic scars(HS)after burns.Methods:With toluidine blue and mast cell tryptase (MCT) for immuno- histochemical stainig,and with the aid of electron microscope,67 specimens of HS from patients with HS on their face and neck for 3-27 mo were examined.They were divided into 4 groups according to wound healing time (HS1,≤6mo,n=14;HS2,7-12mo,n=16;HS3,13-18mo,n=20;HS4,≥19mo,n=17).10 normal skin spec- iments obtained from face and neck operations served as control group (NS,n=10).HS1 specimens were all con- firmed by follow up.All samples were obtained with the approval of hospital authorities and patients.Results:MC containing abundant MCT positive granules could be observed during early stage (≤6mo) of the HS,and MCT positive substances were also seen in the surrounding excellular matrix of scar tissue.Ultrastructural examination revealed that there was close contact between granule rich MC and fibroblasts.There was membrane fusion and granule migtsyion.Following hyperplasis of the scar and maturation,the density of MC was significantly decreased (P<0.05-0.001),and they were mainly distributed in collagenous fibres and edges of collagenous nodules at the late stage (≥13mo) of HS.Membranous protuberance and granular substances of MC were obviously reduced. Conclusion:Characteristics of distribution of MC and their active biological behavior indicated that MC might be involved in collagen structural formation of the HS.