Wnt5a在增生性瘢痕中的表达及其临床意义

Wnt5a Expression in Hypertrophic Scar and its Clinical Significance

目的:探讨Wnt5a在增生性瘢痕中的表达及其临床意义。方法:选择12例增生性瘢痕患者,术中取成熟期增生性瘢痕6份,增殖期增生性瘢痕6份,正常皮肤组织6份。光镜下观察其形态学的差异,通过免疫组化技术检测和比较其Wnt5a阳性表达的细胞面积率。结果:与正常皮肤相比,增殖期增生性瘢痕中有大量的成纤维细胞,胶原纤维含量丰富,且排列紊乱,其间有大量的炎性细胞,成熟期增生性瘢痕也含有丰富的成纤维细胞和胶原,但炎性细胞很少。增殖期增生性瘢痕和成熟期增生性瘢痕组织中真皮浅层和真皮深层Wnt5a阳性表达的细胞面积率均显著高于正常皮肤组织(P<0.05),且增殖期增生性瘢痕组织中Wnt5a阳性表达的细胞面积率显著高于成熟期增生性瘢痕(P<0.05)。但正常皮肤组织、成熟期增生性瘢痕、增殖期增生性瘢痕各组间真皮浅层与真皮深层Wnt5a阳性表达的细胞面积率比较均无显著性差异(P>0.05)。结论:Wnt5a的表达上调可能在增生性瘢痕的形成中起重要作用,并可能与增生性瘢痕的增殖活性有关。

Objective： To investigate WntSa expression in hypertrophic scar as well as its clinical significance. Methods： In the present study, we chose 12 patients with hypertrophic scar. Six mature hypertrophic scar tissues, six proliferative stage hypertrophic scar tissues, and six normal skin tissues were obtained by operation. Morphological differences among these samples were observed, lmmuno- histochemical assay was applied to detect and compare the Wnt5a positive cells area ratio. Results： When compared with normal dermis, proliferative stage hypertrophic scar had lots of fibroblasts, inflammatory cells and collagen fiber, which was disarranged, while mature hypertrophic hypertrophic scar also had lots of fibroblasts and collagen fiber, but fewer inflammatory cells. Moreover, in whatever light layer or deep layer of dermis, the Wnt5a positive cell area ratio in mature hypertrophic scar and in proliferative stage hypertrophic scar was significantly increased, when compared with that in normal dermis （P〈0.05）. Furthermore, the Wnt5a positive cell area ratio in pro- liferative stage hypertrophic scar was higher than that in mature hypertrophic scar （P〈0.05）. However, in whatever normal dermis, prolif- erative stage hypertrophic scar or mature hypertrophic scar, the Wnt5a positive cell area ratio between light layer and deep layer showed no difference （P〉0.05）. Conclusion： Wnt5a upregulation may play an important role in the formation of hypertrophic scars, and may be related to the proliferative activity of hypertrophic scars.