肝素酶和血管内皮生长因子在进行期寻常型银屑病皮损中的表达及意义

目的 探讨肝素酶(heparanase，HPA)和血管内皮生长因子(vascular endothelial growth factor，VEGF)在进行期寻常型银屑病患者皮损中的表达水平及意义。 方法 选取嘉兴市第一医院皮肤科门诊2015年1月—2016年12月收治的进行期寻常型银屑病患者25例。采用免疫组化S-P法检测25例进行期寻常型银屑病患者皮损标本和20例对照组健康皮肤标本的HPA和VEGF水平并进行比较。 结果 HPA表达产物主要位于细胞浆，呈棕黄色颗粒状，银屑病组表达集中于棘层、基底层与乳头层血管内皮细胞，对照组呈阴性表达。VEGF表达产物主要位于细胞浆，呈棕黄色颗粒状，银屑病组表达集中于棘层与乳头层血管内皮细胞，基底层也有少量表达，对照组呈阴性表达或基底层少量表达。对照组HPA和VEGF表达阳性率分别为0%、5%，银屑病组HPA和VEGF表达阳性率分别为88%、96%，银屑病组HPA和VEGF表达阳性率均显著高于对照组(均P<0.05)。银屑病皮损中HPA和VEGF的表达呈正相关(r=0.585，P<0.05)。 结论 HPA和VEGF在进行期寻常型银屑病皮损中的表达水平明显高于正常皮肤，二者在银屑病发病机制中起到重要作用，可作为进行期寻常型银屑病病理诊断的辅助指标之一。 

Expression and significance of HPA and VEGF in skin lesions of psoriasis vulgaris at progressing stage

Objective To research the expression level and significance of heparanase (HPA) and vascular endothelial growth factor (VEGF) in the skin lesions of psoriasis vulgaris at progressing stage. Methods The expression of HPA and VEGF in skin specimens of 25 patients with psoriasis vulgaris at progressing stage and 20 cases of normal control were detected by immunohistochemical S-P. Results The expression of HPA was brown-yellow granular and mainly located in cytoplasm. In psoriasis group, HPA was mainly expressed in spinous layer, basal layer and papillary vascular endothelial cells, but negative in healthy control group. The expression of VEGF was brown-yellow granular, mainly in the cytoplasm. In psoriasis group, the expression of VEGF was mainly in the spinous and papillary vascular endothelial cells, and a little in the basal layer. In healthy control group, the expression of VEGF was negative or a little in the basal layer. The positive rates of HPA and VEGF were 0% and 5% in the control group, and 88% and 96% in the psoriasis group. The positive rates of HPA and VEGF expression in psoriasis group were significantly higher than those in the control group (all P<0.05). The expression of HPA and VEGF in psoriatic lesions was positively correlated (r=0.585, P<0.05). Conclusion The expression of HPA and VEGF in skin lesions of psoriasis vulgaris at progressing stage is significantly higher than that in normal skin. The two factors play an important role in the pathogenesis of psoriasis, and can be used as an auxiliary index for pathological diagnosis of psoriasis vulgaris.