瘢痕疙瘩上皮细胞增殖和免疫诱导与毛囊-皮脂腺结构破坏

目的 探讨瘢痕疙瘩（K）上皮细胞生物学行为对毛囊-皮脂腺（HFSG）转归的影响。方法 收集K边缘部位和正常皮肤（NS）标本，采用组织化学和免疫组化染色方法，观察结构正常和异常的HFSG上皮细胞表达免疫黏附分子和细胞角蛋白14（CK14）以及局部活性淋巴细胞浸润情况。结果 与NS不同，K-HFSG上皮细胞异常增殖，结构畸变、解体或形成复层鳞状上皮（皮岛样）结构，其密度随着结缔组织增生、成熟而逐渐降低；在强表达细胞间黏附分子（ICAM）-1、D-相关人类白细胞抗原位点（HLA-DR）和CK14的K-HFSG周围，有相应的CD4、CD45RO和γ-干扰素（IFN-γ）阳性免疫细胞浸润，二者之间统计学呈明显的正相关。结论 K-HFSG结构破坏与反应性上皮细胞增生免疫诱导增强有关。

Relationship between the proliferation and immunoinduction of epithelial cells and the destruction of hair follicles and sebaceous glands in keloids

OBJECTIVE: To investigate the influence of biological behavior of epithelial cells on the hair follicles and sebaceous glands (HFSG) structure in keloids (K). METHODS: The expression of intercellular adhesion molecule (ICAM)-1, D-related human leucocyte antigen (HLA-DR), and cytokeratin (CK) 14 on epithelial cells and the amount of activity T-lymphocytes were detected in specimens of keloid edge and normal skin with immunohistochemical and histological methods. RESULTS: In comparison with normal skin specimens, epithelial cells were proliferated in K-HFSG presented structural aberration and disintegrate or abnormally to form solid-epithelial island-like structure, and the density of HSFG with hyperplasia and the ageing scar in keloids was apparently decreased. They strongly expressed ICAM-1, HLA-DR, and CK14 in the epithelial cells, there were many immunologic cells which expressed CD4, CD45RO, and interferon (IFN)-gamma around the K-HFSG. The expressed level of epithelial cells was positively correlated with the density of immunologic cells nearby K-HFSG. CONCLUSION: It could be concluded that the reactivity with hyperplasia and immunoinduction of epithelial cells might be associated with the destruction of the some HFSG structure in the keloids.