中耳炎患者胆脂瘤中转化生长因子α的表达水平的临床意义

Clinical significance of the expression of transforming growth factor in the cholesteatoma of the patients with tympanitis

目的评估中耳炎患者胆脂瘤内转化生长因子α(TGF-α)的水平,探讨其对上皮细胞增生潜在的影响机制。方法分别取胆脂瘤上皮(22例)、正常外耳道组织标本(10例),将其作成石蜡切片,根据免疫组织化学法(S-P)对两类标本进行染色处理,观察TGF-α的表达水平;借助彩色图文系统定量分析所得的染色结果。结果 TGF-α表达在胞浆内呈阳性,在胆脂瘤上皮组织内则可见中等/强阳性两种反应;由基底层到角质层,32例标本的染色程度明显增强;皮下结缔组织内观察到少量的阳性细胞,多以纤维、巨噬细胞为主;表层内外耳道皮肤组织可见大量的阳性表达:其中有8例标本处于弱阳性;10例肉芽组织中,均发现分散的阳性细胞,且血管内皮细胞检测为中等阳性。TGF-α积分吸光度在胆脂瘤上皮检测值为(2.431±0.585),正常外耳道表皮检测为(1.463±0.145),差异有统计学意义(P<0.05)。结论胆脂瘤组织内,TGF-α表达明显高于正常皮肤组织,推测可调节甚至诱发胆脂瘤上皮的增生。

Objective To evaluate the expression of transforming growth factor α（TGF-α） in cholesteatoma in patients with tympanitis,and to explore the potential mechanism of the effect of TGF-α on the proliferation of epithelial cells.Methods Normal external ear canal （10 cases）,cholesteatoma tissue specimens （22 cases） were selected,which were made paraffin sections according to immunohistochemical （S-P） staining in two specimens,and the expression level of TGF-α was observed;quantitative analysis results were conducted by color graphic system.Results The TGF-α expression in the cytoplasm was positive.And it showed moderately or strongly positive reaction in cholesteatoma.From basal layer to stratum corneum,staining degree of 32 cases were obviously enhanced.A small amount of positive cells were observed in subcutaneous connective tissue,fiber cells and macrophage cells accounted mostly.Surface internal and external ear canal the skin tissue showed a large amount of TGF-α positive expression：8 specimens were weakly positive,and in 10 cases of granulation tissues,scattered positive cells were found,and the was moderately positive.Integral absorbance of TGF-α in cholesteatoma was （2.431±0.585）,which of the normal ear canal epidermis was （1.463±0.145）,difference was statistically significant （P〈0.05）.Conclusion Expression of TGF-α in cholesteatoma tissue is higher than that in normal skin tissues,so TGF-α may be involved in the regulation or even induce the proliferation of cholesteatoma epithelium.