糖皮质激素对鼻息肉中细胞角蛋白13表达的影响

Influence of glucocorticoid on expression of cytokeratin 13 in nasal polyps

目的：探讨细胞角蛋白13（CK13）在鼻息肉上皮细胞增生分化过程中的作用。方法选取慢性鼻-鼻窦炎（伴鼻息肉）患者60例。其中 A组30例患者，术前未应用糖皮质激素直接进行手术治疗，术中取下鼻息肉组织；B组30例患者应用糖皮质激素类药物治疗3～5 d后手术治疗，术中取下鼻息肉组织。C组10例为正常中鼻甲组织对照组。采用免疫组化（二步法）检测标本中CK13的表达。结果 A组CK13的阳性表达率高于B组，差异有统计学意义（χ2＝11．482，P＝0．009），C组正常中鼻甲组织上皮细胞未见CK13的阳性表达。结论（1）CK13在鼻息肉组织中不同上皮表达程度的差异，反映了 CK13在鼻息肉在发生发展过程中的动态变化；使用糖皮质激素治疗后鼻息肉组织中 CK13蛋白表达有所下降，说明糖皮质激素对鼻息肉的增生、分化有抑制作用。

Objective To research the role of cytokeratin13（CK13）during hyperplasia and differentiation process of epithelial cells in nasal polyps.Methods 60 cases of chronic rhinosinusitis （complicating nasal polyps）were selected.Among them,the group A（30 cases）was directly performed the operation without using preoperative glucocorticoid and the nasal polyp tissue was taken during operation;the C group（30 cases）was performed the operation after using glucocorticoid for 3-5 d and the nasal polyp tissue was intraoperatively taken.Other 10 cases of normal concha nasalis media tissue were taken as the control group.The immunohisto-chemical method（two step method）was adopted to detect the expression of CK13.The obtained data were statistically analyzed by SPSS 11.5.Results The positive expression of CK13 in the group A was higher than that in the group B with statistical difference between them（χ2=11.482,P=0.009）.The epithelial cells of normal concha nasalis media tissue in the group C had no positive ex-pression of CK13.Conclusion （1）The difference of CK13 expression in different epithelias of nasal polyps reflects the dynamic change of nasal polyps during the development and progress process;（2）the expression of CK13 is decreased after using glucocorti-coid,which indicating that glucocorticoid has the inhibiting effect on the hyperplasia and differentiation of nasal polyps.