自然消退倾向跖疣皮损中朗格汉斯细胞与T淋巴细胞检测分析

目的通过对自然消退倾向跖疣及无消退迹象跖疣皮损中朗格汉斯细胞与T淋巴细胞的检测分析,探讨跖疣的发生、发展与局部免疫的相关性。方法根据近期疣体数目增减及疣体大小、自觉症状情况,在皮肤科足病专科门诊收集自然消退倾向跖疣22例与无消退迹象跖疣18例。用外科手术的方法将两组患者疣体切除,所取疣体皮损,常规石蜡切片,用CD1a,CD3,CD4,CD8单克隆抗体进行免疫组化染色,比较两组患者CD1a+朗格汉斯细胞(LC),CD3+,CD4+,CD8+平均密度,CD4+/CD8+比值及LC的形态分布,观察两组患者的局部免疫状况。结果与自然消退倾向组相比,无消退迹象组CD1a+LC大多散在分布于表皮下部,树突状突起明显减少、缩短或消失;无消退迹象组CD1a+LC,CD4+平均密度及CD4+/CD8+比值明显低于自然消退倾向组(P<0.05);无消退迹象组CD8+平均密度明显高于自然消退倾向组(P<0.05);两组中CD3+平均密度差异无统计学意义(P>0.05)。结论在无消退迹象组中存在局部免疫缺陷,局部免疫的恢复与疣体的自行消退有相关性。

Analysis of Langerhans Cells and T-lymphocyte in Plantar Warts with Spontaneous Regression

Objective To detect the Langerhans cells and T lymphocytes in plantar warts with the tendency of spontaneous regression and explore its occurrence, development and relevance of local immunity. Methods According to the recent changes of plantar warts′ number as well as size and patients′ self-feeling symptoms,22 plantar wart with spontaneous regression and 18 cases without the regression sign were selected from the Foot Specialist Out-patient. Then we removed those warts with the surgical operation,taking the routine paraffin section on those removed warts,going on immunohistochemical staining with CD1a,CD3,CD4,CD8 monoclonal antibody to compared their average density of CD1a+LC,CD3+,CD4+,CD8+,ratio of CD4+/CD8+ and the LC modality distribution. The local immune status of the two groups was observed at the same time. Results Compared with the spontaneous regression group,CD1a+LC in the group without signs of regression mostly scattered in the lower epidermis and the dendritic processes were also significantly less,shorter than the other group and even disappeared. The average density of LC,CD4,and CD4/CD8 ratios in the group without signs of regression were significantly lower than those in spontaneous regression group (P<0.05),while CD8 were significantly higher than those in spontaneous regression group (P<0.05).There was no significant difference about the average density of CD3 between the two groups (P>0.05). Conclusion The group without signs of regression has local immune deficiency. The recovery of local immune is closely related to the spontaneous regression of plantar wart.