内皮素1及其受体A在尖锐湿疣及鲍恩样丘疹病皮损中的表达及意义

内皮素（endothelin,ET）是含有21个氨基酸的生物活性肽,具有多种生物学效应。近年研究发现它是一种肿瘤相关生长因子,且与人乳头瘤病毒human papilloma virus,HPV）感染相关的宫颈癌发生有关。笔者采用免疫组化SP碱性磷酸酶法检测ET-1及内皮素受体A（endothelin A receptor,EDNR—A）在HPV感染性疾病尖锐湿疣及鲍恩样丘疹病中的表达,以了解其中是否也存在内皮素及其受体的表达异常,并探讨其可能的作用机制。     

鲍恩样丘疹病

患者男,39岁。 主诉：阴囊、阴茎暗紫褐色丘疹伴瘙痒2年。 现病史：患者于2年前无明显诱因阴囊部出现大小不等的暗紫色丘疹,伴瘙痒。近2个月来阴囊皮损渐增多,瘙痒加剧,于2004年9月至我院就诊。     

Toll样受体在尖锐湿疣皮损中的表达

目的 探讨尖锐湿疣皮损中Toll样受体（TLR）各亚型的表达。方法 将尖锐湿疣患者的病损组织标本冰冻切片经免疫组化染色检测10种TLR亚型的表达情况,以正常皮肤组织作对照,比较两者TLR表达谱的差异。结果 正常表皮角质层和颗粒层TLR6、9呈强阳性表达,TLR1、3、10呈中等强度表达,TLR2、4、5、7、8弱表达,棘层和基底层细胞不表达或弱表达TLR;尖锐湿疣皮损表皮中除基底层弱表达或不表达TLR外,其余细胞层TLR1、3、6、9强阳性表达,TLR4、8、10中等强度表达,TLR2、5、7弱表达。两组皮肤的真皮层均未见明显TLR阳性细胞。结论 尖锐湿疣皮损增生的角质形成细胞中TLR表达较正常皮肤明显增高,尤以TLR1、3、6、9亚型为著,可能与HPV感染启动机体抗病毒免疫有关。     

尖锐湿疣并发外阴鳞状细胞癌及鲍恩样丘疹病1例

外阴尖锐湿疣比较常见,但同时并发鳞状细胞癌(简称鳞癌)和鲍恩样丘疹病者比较少,现将我们诊治的1例报告如下.     

鲍恩样丘疹病发病机制的进展

鲍恩样丘疹病是一种较少见的肛周外生殖器疾病，该病与尖锐湿疣和鲍恩病有诸多相似之处。研究提示，鲍恩样丘疹病主要是由高危型人乳头瘤病毒感染引起，机体免疫系统改变对其有促进作用。感染细胞致癌蛋白p53和p16的异常表达、端粒酶活性的增高与鲍恩样丘疹病的发生发展密切相关。细胞凋亡在鲍恩样丘疹病的良性生物学行为中可能起一定作用。     

尖锐湿疣及鲍恩样丘疹病皮损中高危型人乳头瘤病毒感染与端粒酶表达的关系

目的:研究尖锐湿疣(CA)与鲍恩样丘疹病(BP)皮损中高危型人乳头瘤病毒(HPV)感染与端粒酶表达的关系。方法:采用PCR方法检测HPV类型,免疫组化方法检测CA和BP皮损中人类端粒酶反转录酶(hTERT)的表达。结果:CA和BP皮损中hTERT表达均比正常对照组高(P均<0.01),BP又较CA表达高(P<0.01)。CAHPV16阳性组hTERT表达较HPV16阴性组高,其差异有统计学意义(P<0.05);BP不同HPV型之间hTERT表达的结果与CA相同;以上各组均比正常对照组表达强度高(P<0.05)。结论:非恶性增殖性疾病中亦有端粒酶不同程度的表达;以HPV16为代表的高危型HPV感染与端粒酶表达有相关性。     

色素性鲍恩样丘疹病1例

患者男,32岁。因包皮系带两侧出现灰黑色斑块7个月余,于2007年3月来我科就诊。患者于2006年8月发现阴茎冠状沟近包皮系带处有一绿豆大肤色丘疹,7d后在包皮系带对侧的相邻部位又出现一米粒大淡红色丘疹。因两处丘疹既无破溃也无不适感,故未行诊治。其后,皮损渐增大,颜色加深,最终呈灰黑色斑块。曾自行外用治疗尖锐湿疣的“绝疣霸”,     

咪喹莫特乳膏治疗鲍恩样丘疹病疗效观察

目的 探讨5%咪喹莫特乳膏治疗鲍恩样丘疹病（BP）的疗效和对复发的影响.方法 回顾性分析39例鲍恩样丘疹病患者,第一组15例,单纯外用5%咪喹莫特乳膏,每周3次,疗程8周.第二组12例,应用CO2激光治疗.第三组12例,CO2激光联合5%咪喹莫特乳膏治疗.三组随访时间均为3个月.结果 第一组33.33%（5/15）的患者获得痊愈,无1例复发,不良反应主要表现为红斑、水肿、糜烂和疼痛,无系统不良反应.第二组CO2激光治疗后,12例全部痊愈,但66.66%（8/12）患者复发.第三组治疗后12例痊愈,仅25%（3/12）患者复发.结论 5%咪喹莫特乳膏是治疗鲍恩样丘疹病的有效药物,尤其是对皮损较小者,疗效好、复发率低.对于肥厚性和/或伴有轻度疣状损害者,CO2激光治疗后联合5%咪喹莫特乳膏可降低复发率.     

儿童外阴鲍恩样丘疹病1例

鲍恩样丘疹病(bowenoid papulosis)是一种较少见的外阴和会阴部的皮肤病.现将笔者诊治的1例儿童外阴鲍恩样丘疹病报告如下.     

鲍恩样丘疹病42例临床分析

鲍恩样丘疹病（bowenoid papulosis,BP）是一种好发于中青年人外生殖器皮肤的良性丘疹病,容易与多种疾病混淆而造成误诊、误治。笔者将1998年5月-2005-3月确诊为BP的42例患者的临床资料进行回顾性分析,现将结果报告如下。     

尖锐湿疣、鲍恩样丘疹病、Bowen病及外阴鳞状细胞癌皮损中端粒酶的表达

目的 探讨端粒酶在正常组织、良性增殖性疾病及恶性肿瘤中的表达情况及其临床意义。方法 采用免疫组化方法检测皮损中端粒酶逆转录酶(hTERT)蛋白的表达情况,并对所有鲍恩样丘疹病和Bowen病病例进行组织病理分析。结果 正常人对照组、尖锐湿疣组及外阴鳞状细胞癌组中任两组间hTERT表达强度差异均有统计学意义,其阳性率依次增高。鲍恩样丘疹病组较尖锐湿疣组hTERT表达强度高,两组差异有统计学意义;虽与Bowen病组比较差异无统计学意义,但较外阴鳞状细胞癌组表达强度低,差异有统计学意义。组织病理上,Bowen病比鲍恩样丘疹病细胞异形性更明显。结论 端粒酶在正常组织、良性增殖性疾病及恶性肿瘤中的表达强度呈梯度升高,提示端粒酶激活在细胞增生及永生化中均发挥重要作用。     

Immunosuppression in men with bowenoid papulosis

The immune status of four men with bowenoid papulosis was evaluated. Each case had been refractory to multiple methods of treatment. Three of the men had other infections and demonstrated a depletion of T4-helper cells. Two of these patients were anergic on skin testing, and the third showed weak reactivity. The fourth patient, who had no evidence of additional infections, had a normal T4 value and T4/T8 ratio, but was anergic on skin testing. All the men were serologically negative for human immunodeficiency virus antibodies. One of the immunosuppressed patients developed squamous cell carcinoma of the tongue, which, along with his bowenoid papulosis, contained human papillomavirus 16 DNA. We suggest that patients with persistent bowenoid papulosis be investigated for altered immune status and followed up as potential candidates for the development of epithelial malignant neoplasms.     

鲍恩样丘疹病皮损中HPV16、18的检测

目的：探讨人乳头瘤病毒（HPV）16、18在鲍恩样丘疹病皮损中的感染情况。方法：采用杂交捕获试验筛选高危型HPV和低危型HPV阳性标本,对高危型HPV阳性标本经PCR技术检测其HPV16、18DNA阳性者。结果：45例鲍恩样丘疹病患者皮损中34（75.6%）例为高危型HPV阳性,在高危型HPV阳性标本中82.2%（28/34）为HPV16阳性,5.9%（2/34）为HPV18阳性,8.8%（3/34）HPV16、18均阳性,2.9%（1/34）未检测到HPV16及HPV18DNA。结论：多数鲍恩样丘疹病皮损中存在高危型HPV感染,尤其HPV16,故高危型HPV16感染与鲍恩样丘疹病的发生、发展密切相关。     

Toll样受体2和4在银屑病皮损中的表达

目的研究Toll样受体（TLR）2和4在银屑病皮损中的表达，探讨其与银屑病发病的关系。方法选用16例滴状银屑病、13例斑块状银屑病患者及10例正常人皮肤的石蜡切片．用免疫组化的方法研究TLR2和TLR4的表达。结果10例正常人皮肤的基底层均有较弱的TLR2表达而无TLR4表达．真皮血管内皮细胞未见TLR2及TLR4表达。所有16例滴状银屑病、13例斑块状银屑病皮损的基底细胞层均可见明显的TLR2表达，棘层也有弱表达；TLR4则呈现表皮全层的弥漫性强表达。银屑病真皮浅层血管内皮细胞可见明显的TLR2及TLR4表达。结论TLR2、TLR4在银屑病皮损均有表达，TLR4的表达更高：提示感染相关免疫与银屑病发病关系密切。     

Spontaneous regression of bowenoid papulosis of the penis

In the last decade, bowenoid papulosis of the genitalia has been recognized to be a distinct entity. It is distinguished from Bowen's disease, which it resembles histologically, on the basis of clinical data such as onset at an earlier average age, smaller size of lesions, and multiplicity of lesions. A 23-year-old man with bowenoid papulosis of the penis is presented. The lesions were present for two months prior to diagnosis. All of the lesions resolved without treatment within two months of diagnosis. A conservative approach to treatment of this condition is advocated.     

Morphometric assessment of nuclei in Bowen's disease and bowenoid papulosis

Background: Occasionally, Bowen's disease and bowenoid papulosis cannot be distinguished in microscopic finding. Their clinical presentations are quite different from one another. The purpose of this study was to evaluate the histological differences in Bowen's disease and bowenoid papulosis, by comparing the size and shape of nuclei, using image analysis system.
Methods: We performed morphometric assessment on 13 specimens of Bowen's disease and eight specimens of bowenoid papulosis using an image analysis system, and the following parameters were calculated, such as nuclear contour index (NCI), irregularities of nucleus (IN), form factor (form AR) and circulatory factor (form PE).
Results: For NCI, there were significant differences between the Bowen's disease and bowenoid papulosis, and IN also shows significant differences between these two dis-eases, showing that Bowen's disease has more corrugated or indented nucleus contour than bowenoid papulosis. In the parameter of form PE, there were significant differences between the two diseases, indicating that Bowen's disease has more oval-shaped nuclei than bowenoid papulosis. There were no significant differences in form factor between Bowen's disease and bowenoid pupulosis.
Conclusions: Significant differences were found in the morphometric evaluation between Bowen's disease and bowenoid papulosis. The nuclei were larger, more oval and more irregular margins in Bowen's disease than bowenoid papulosis.