瘢痕疙瘩和增生性瘢痕鉴别的实验研究

为寻找鉴别增生性瘢痕和瘢痕疙瘩的新途径,对两种病理性瘢痕的组织形态结构进行比较,并用免疫组织化学方法检测抑凋亡蛋白Bcl-2在二者成纤维细胞上的表达,结果发现两种病理性瘢痕在光镜下均出现过多的成纤维细胞、胶原纤维及微血管.超微结构均发现各时期的成纤维细胞,多数细胞富含粗面内质网和高尔基复合体,胶原微纤维排列紊乱,证实二者在组织形态上难以区别.而Bcl-2蛋白在瘢痕疙瘩中成纤维细胞的表达明显高于增生性瘢痕(P＜0.005),提示免疫组织化学方法可能有助于鉴别二者.

Experimental Study of Difference between Keloid and Hypertrophic Scar

Objective:To find the methods of differential diagnosis between keloid and hypertrophic scar.Method:The morphological characters of keloid and hypertrophic scar were compared under light microscope and electron microscope.Immunohistochemistry method was used to detect the expression of Bcl-2 protein in fibroblast of both lesions.Results:Both keloid and hypertrophic scar showed lots of fibroblast,microvessels and collagen fibers.The ultrastructures of both lesions were found that most fibroblasts were of active celltypes,they contained abundant coarse endoplasmic reticulum,prominent Gogi complexes,and the fibrils in the lesions were irregularly arranged.Meanwhile,the expression of Bcl-2 protein in keloid was significantly higher than that in hypertrophic scar ( P <0 005).Conclusion:The morphological characters of keloid were hardly to be differentialted from hypertrophic scar,but the immunochemical differences of Bcl-2 protein might be useful in the differential diagnosis between keloid and hypertrophic scar.