皮肤良恶性肿瘤中p16、p21ras和ki-67蛋白表达研究

目的:探讨细胞周期依赖性激酶抑制蛋白、癌基因蛋白和细胞增殖指数在皮肤基底细胞癌(BBC)、鳞状细胞癌(SCC)和脂溢性角化病(SK)中的表达,并就其结果进行分析。方法:采用DAKO En-Vision免疫组化法检测了18例BCC、10例SCC皮肤恶性肿瘤和17例SK皮肤良性肿瘤组织中p16、p21~(ras)及ki-67蛋白的表达。结果:BCC肿瘤组织中p16、p21~(ras)及ki-67阳性表达率分别为61.1％、77.8％、94％;SCC肿瘤组织中阳性表达率分别90％、50％、90％;SK组织中阳性表达率分别为70.5％、88.2％、94.1％。BCC中p16阳性率明显低于SCC(P<0.01);SCC中p21~(ras)阳性率明显低于SK(P<0.01);三组ki-67蛋白均呈高表达,它们之间无统计学差异。结论:p16、p21、ki-67基因与肿瘤的发生发展及增殖程度密切相关。p16、p21~(ras)基因蛋白的缺失程度或超表达在临床上可作为对良恶性肿瘤预后判断的参考值,它们的表达可能与肿瘤的分化程度有关。     

A majority of proliferating T cells in cutaneous malignant T cell lymphomas may lack the high affinity IL-2 receptor (CD25)

IL-2 is a major growth factor for all T-cell subsets acting via a specific membrane receptor. To investigate its role in the pathogenesis of cutaneous T-cell lymphomas (CTCLs), we analysed the expression of high-affinity IL-2 receptors (IL-2Rs) on proliferating cells in these disorders. We showed by immunohistochemical double staining that most cycling cells do not express high-affinity IL-2Rs. Four T-cell lines were established from patients with CTCLs. Two lines required both IL-2 and IL-4 for growth, one line required IL-2 and one line IL-4 alone. The last of these lacked expression of the IL-2R -chain. Thus, IL-2 may not be the only, or the most important, growth stimulus in CTCLs and reactive skin infiltrates. T helper cells, which dominated the infiltrate, might represent TH2 cells.     

Permeability barrier disruption alters the localization and expression of TNFα/protein in the epidermis

Previous studies have shown that (1) epidermal TNF mRNA levels are increased following acute disruption of the cutaneous permeability barrier; (2) this increase is maximal at 1 h and decreases to control levels by 8 h; and (3) in essential fatty acid-deficient (EFAD) mice, a chronic model of barrier perturbation, TNF mRNA levels are also elevated several-fold over controls. In the present study we determined, using immunocytochemical procedures, epidermal TNF protein levels following either acute of chronic barrier disruption and the localization of any increase. Frozen, paraffin and Antibed sections of skin were incubated with polyclonal anti-mouse TNF antisera and detection was accomplished by either immunoperoxidase or fluorescence procedures. We found that (1) TNF-immunoreactive protein was present in normal mouse epidermis, and was primarily localized to the upper nucleated layers where it displayed a diffuse cytosolic pattern; (2) acute disruption of the barrier with acetone or tape-stripping resulted in TNF staining that was more intense throughout all of the nucleated epidermal cell layers in comparison with normal epidermis; (3) the increase in TNF staining occurred as early as 2 h after barrier disruption; and (4) increased TNF staining was also observed in the stratum corneum of EFAD mice. These results indicate that epidermal TNF protein levels increase after both acute and chronic barrier disruption, and are consistent with the hypothesis that TNF may signal and/or coordinate portions of the cutaneous response to barrier disruption.     

胎盘型谷胱甘肽转换酶在皮肤角朊细胞肿瘤中的表达

为了探讨谷胱甘肽转换酶π（ＧＳＴπ）与皮肤角朊细胞肿瘤发生的关系，采用免疫组化技术检测了４５例皮肤角朊细胞肿瘤和５例正常皮肤。结果∶ＧＳＴπ在正常皮肤主要表达于颗粒细胞层、大部分棘细胞层和外毛根鞘、小汗腺。在日光性角化病、Ｂｏｗｅｎ病、基底鳞状细胞癌和鳞状细胞癌中胞浆和部分胞核ＧＳＴπ阳性，基底细胞癌胞浆弱阳性，部分脂溢性角化症和角化棘皮瘤胞浆呈弱阳性。本研究提示ＧＳＴπ主要存在于表皮上层，并在皮肤角朊细胞肿瘤发生中起一定作用。     

皮肤淋巴腺瘤二例组织学及免疫组化研究

2例均为发生于面部的单发结节,光滑,粉红色,缓慢增大.组织病理:真皮中不规则的上皮细胞小叶,边缘由基底样细胞呈栅栏状排列,团块中心由透明细胞构成,小叶中及间质中可见大量的小淋巴细胞浸润.免疫组化:淋巴细胞以CD3阳性为主,少量的CD20阳性细胞,上皮团块及周围间质中较多的S-100+CD1a+树突细胞,细胞角蛋白7、细胞角蛋白20、癌胚抗原均为阴性,1例团块中央少量细胞上皮膜抗原和CD30表达.根据组织病理和免疫组化结果,明确为皮肤淋巴腺瘤,其主要的浸润细胞是CD3阳性淋巴细胞.     

种痘水疱病样皮肤T细胞淋巴瘤1例

患儿女,5岁。面部、手背反复发作红斑、水疱4年,皮疹消退后遗留下痘疮样萎缩性瘢痕。血清抗EBVIgG(+)、EBV IgM(-)。皮损组织病理示:真皮全层及皮下脂肪弥漫性淋巴细胞浸润,伴少量嗜酸性粒细胞,可见核分裂象。免疫组化示LCA(+)、UCHL1(+)、CD3(+)、CD5(+)、CD10(+)、CD99(弱+)。基因重排检测示:TCR-γ基因JVI(+)、JVII(弱+)。诊断:种痘水疱病样皮肤T细胞淋巴瘤。明确诊断后转至本院血液科,予CHOP方案化疗,现随访中。     

Clonal disease in extracutaneous compartments in cutaneous T-cell lymphomas. A comparative study between cutaneous T-cell lymphomas and pseudo lymphomas

Extracutaneous involvement is a sign of poor prognosis in cutaneous T-cell lymphomas (CTCL). Unfortunately it becomes clinically and histologically manifest only late in the course of the disease. It was the purpose of this study to detect clonality in peripheral blood, lymph nodes and bone marrow samples at times when extracutaneous involvement cannot other-wise be demonstrated. In addition to skin biopsies, peripheral blood, lymph node and bone marrow samples from a total of 25 patients were analysed by Southern blotting for clonal gene rearrangement of the T-cell receptor β-chain. Six of the patients were suffering from mycosis fungoides (MF), four from non-MF CTCL (pleomorphic T-cell lymphomas), seven from Sézary syndrome (SS), eight from pseudolymphoma (insect bites) (PSL), and one from lymphomatoid papulosis (LP). Clonal TcR b gene rearrangements were found in patients with MF in four of five skin probes as well as in two of two lymph node samples and in one of two peripheral blood samples. In SS patients, all skin probes (seven of seven), lymph node samples (six of six), peripheral blood samples (six of six) and one bone marrow specimen had a clonal TcR β gene rearrangement. In patients with non-MF CTCL, two of four skin, zero of two peripheral blood and one of one bone marrow samples with clonal T cells were detected. All investigated patients showed exactly the same rearrangement pattern at extranodal sites and in the skin, which is proof for the same clone in all compartments. In contrast, no rearrangements were detected in LP and PSL (zero of eight skin probes, zero of two peripheral blood samples). Our results provide strong evidence for an early systemic spread of neoplastic cells in CTCL. However, an initial tumour burden has to be reached in order to lead to a clinically and prognostically relevant manifestation.     

皮肤淋巴腺瘤二例组织学及免疫组化研究

2例均为发生于面部的单发结节,光滑,粉红色,缓慢增大.组织病理:真皮中不规则的上皮细胞小叶,边缘由基底样细胞呈栅栏状排列,团块中心由透明细胞构成,小叶中及间质中可见大量的小淋巴细胞浸润.免疫组化:淋巴细胞以CD3阳性为主,少量的CD20阳性细胞,上皮团块及周围间质中较多的S-100+CD1a+树突细胞,细胞角蛋白7、细胞角蛋白20、癌胚抗原均为阴性,1例团块中央少量细胞上皮膜抗原和CD30表达.根据组织病理和免疫组化结果,明确为皮肤淋巴腺瘤,其主要的浸润细胞是CD3阳性淋巴细胞.     

A comparison of the effect of different surgical gloves on objective measurement of fingertip cutaneous sensibility

INTRODUCTION

The prudent selection of surgical gloves can deliver significant efficiency savings. However, objective data are lacking to compare differences in cutaneous sensibility between competing gloves. Therefore, the present study examined the use of a single comparable model of sterile surgical glove from two competing providers, Gammex PF HyGrip® (Ansell Limited, Red Bank, NJ, USA) with Biogel® (Mölnlycke Health Care AB, Göteborg, Sweden).

SUBJECTS AND METHODS

Cutaneous pressure threshold, static and moving two-point discrimination were measured as indices of objective surgical glove performance in 52 blinded healthcare professionals.

RESULTS

The mean cutaneous pressure threshold was 0.0680 ± 0.0923 g for skin, 0.411 ± 0.661 g for Ansell gloves and 0.472 ± 0.768 g for Biogel gloves. Skin was significantly more sensitive than Ansell (P< 0.0001) or Biogel (P< 0.0001) gloves (Wilcoxon signed rank test). There was no statistical difference between Biogel and Ansell gloves (P = 0.359). There was no significant difference between static or moving 2-point discrimination of skin and Ansell gloves (P= 0.556, P = 0.617; Wilcoxon signed rank test), skin and Biogel gloves (P= 0.486, P= 0.437; Wilcoxon signed rank test) or Ansell and Biogel gloves (P= 0.843, P= 0.670; Wilcoxon signed rank test).

CONCLUSIONS

No demonstrable objective difference was found between competing gloves in the outcome measures of cutaneous sensibility and two-point discrimination. However, a difference in subjective preference was noted. Untested factors may underlie this discrepancy, and further research should employ more sophisticated measurements of surgical performance using competing models of surgical glove.     

中国人群体表慢性难愈合创面病原微生物学特征分析

目的:研究体表慢性难愈合创面病原微生物学特征,为选择正确的创面抗感染治疗方法提供依据.方法:采用多中心横断性病例回顾调查研究的方法,对2007-2008年我国17家医院中因体表慢性难愈合创面住院治疗患者的住院病历中有关细菌病原学特征进行记录,分析其规律.结果:共有1 488 201个病案被纳入观察对象,从中获得符合入选...