61例烧伤肥厚性瘢痕形态学观察与细胞增殖活性的研究

Study on the morphology and proliferating activity of hypertrophic scars

目的 探讨肥厚性瘢痕的形态学特点及成纤维细胞增殖活性与其发生的关系。方法 应用光镜和免疫组化染色对61例肥厚性瘢痕、8例正常皮肤进行形态学观察、成纤维细胞平均密度计数和增殖细胞核抗原 (PCNA)表达检测。结果 肥厚性瘢痕按其形态改变可分为增厚期、成熟期和消退期 ,各期间成纤维细胞平均密度相差非常显著 (P <0 .0 1) ;肥厚性瘢痕增厚期、成熟期、消退期和正常对照组间PCNA标记指数差异均无显著性 (P >0 .0 5 )。结论 肥厚性瘢痕发展经历了增厚期→成熟期→消退期的病理过程 ,其成纤维细胞数的多少与细胞增殖活性无关 ,肥厚性瘢痕的形成并非成纤维细胞增生所致。

Objective To explore the relationship between proliferating activity of fibroblast and occurrence of hypertrophic scars (HS). Methods The morphological changes, mean density of fibroblast and the expression of proliferating cell nuclear antigen (PCNA) were detected by using light microscopy and immunohistochemical staining in 61 cases of HS and 8 cases of normal skin. Results According to clinical and pathological changes, HS were divided into proliferating stage, mature stage and regressive stage. The mean density of fibroblast was significantly different among three stages of HS ( P <0.01), but the index of PCNA was not significant different among three stages of HS and normal skin ( P >0.05). Conclusion The development of HS is a pathological process from proliferating stage, through mature stage to regressive stage. The increase of fibroblast in hypertrophic scar is not related to its proliferating activity, its occurrence is not due to proliferation of fibroblast.