尖锐湿疣病理发展过程的研究

目的:从组织学角度探讨尖锐湿疣condylomata acuminate(CA)的基本病变、发生发展过程、病因及病理特征的关系.方法:收集350例病理诊断为CA的病例,观察其病理形态学特征,部分病例做原位杂交、P53与S-100蛋白检测及TEM观察.结果:①CA主要是薄层表皮增殖单位(epidermal proliferation unit)的慢性病毒(HPV6、11)性增生性炎,病变特点是含HPV表皮细胞柱的特殊水变性(CA细胞群),乳头状曾殖、分化及凋亡,三者协同作用是本病的发病基础.②HPV感染DNA见于水变性表皮细胞柱的核中,偶见于胞浆及细胞的间质中.③潜伏在表皮内的HPV及宿主免疫反应低是本病慢性发展及反复发作的原因.结论:CA是表皮增殖单位的慢性病毒性增生性炎.

Further research of the pathologic developing process of condylomata acuminate(CA)

Objective: To explore and discuss the basic pathologic changes,generation and developing process, pathogenesis and the characteristic pathologic changes of CA from histological aspect. Methods: 350 cases diagnosed as CA were collected, patho-morphological characteristics of CA was oberserved, In situ hydridization (ISH) was made in some cases. P53 and s-100 protein were detected and oberseved under electron microscope. Results: 1.CA was chronic, viral, hyperplastic inflammation of shallow layer epidermal proliferation unit, the pathological changes were special hydropic degeneration (CA cell group) of epidermal cell column which contain HPV and papillose hyperplasia of stratum spinosum cell. The cooperation of epidermal infection, differentiation, apoptosis and hyperplasia was the pathogenesis basis 2.DNA infected by HPV was observed in nucli; of epidermal cell column with hydropic degeneration, occasionally was observed in cytoplasm and in matrix. 3.The reason of chronic developing process and recurrence of CA was HPV hidden in epidermis and the low immune response of host. Conclusion: It is sugoested that CA is a viral inflammation of epidermal proliferation unit, and further demonstrates the pathogenesis, characteristics of pathologic changes and the rucurrent reasion of CA .