颞骨胆脂瘤和鳞状细胞癌细胞增殖凋亡的研究

目的观察不同生长方式的颞骨胆脂瘤上皮和鳞状细胞癌细胞的增殖、凋亡特性，探讨胆脂瘤的发生发展规律。方法于颞骨手术中收集侵袭性胆脂瘤37例和非侵袭性胆脂瘤25例，鳞状细胞癌8例，颞骨鳞状细胞癌病灶中胆脂瘤上皮5例，正常颞骨皮肤组织8例，分别采用免疫组织化学SP染色技术及末端转移酶介导的原位缺口末端标记染色（TUNEL）技术检测颞骨胆脂瘤上皮及颞骨鳞状细胞癌组织的细胞增殖和凋亡。结果各种类型胆脂瘤上皮细胞增殖指数（MI）均显著低于颞骨鳞状细胞癌而高于正常表皮；凋亡指数（AI）显著高于正常表皮及颞骨鳞状细胞癌；增殖、凋亡指数比（MI／AI）显著高于颞骨鳞状细胞癌细胞，而与正常表皮差异无统计学意义（P〉0．05）。不同类型胆脂瘤上皮的增殖凋亡指数及增殖凋亡指数相比差异无统计学意义（P〉0．05）。结论颞骨胆脂瘤上皮细胞的生物学特性与颞骨鳞状细胞癌有显著区别，颞骨胆脂瘤上皮细胞的过度增殖和凋亡起着互相调控的作用，但同时也导致了胆脂瘤体积的增大及病变的发展。

Proliferation and apoptosis in cholesteatoma and squamous cell carcinoma of temporal bone

Objective To indentify and characterize cell proliferation and apoptosis in cholesteatoma with different aggressive approaches and squamous cell carcinoma (SCC) of temporal bone and explore the role of cell proliferation and apoptosis in cholesteatoma development. Methods In 37 cases of aggressive cholesteatoma, 25 cases of non-aggressive cholesteatoma, 5 cases of SCC of temporal bone and 8 cases of normal temporal skin tissues, by using immunohistochemistry and TUNEL, cell proliferation and apoptosis were measured respectively. Results The mitosis indexs (MI) of different kinds of cholesteatomas were higher than normal skin, and lower than SCC of middle ear. By contrast, the apoptosis index (AI) of cholesteatoma epithelium was higer than the other two epithelial tissues. There was a similar MI/AI ratio in cholesteatoma and normal meatal skin epithlium. Conclusion The cell biological characteristics of cholesteatoma epithelium aredifferent to those of SCC of middle ear. The hyperprolif-eration of epithelium in cholesteatoma is countered by an increased apoptosis rate while in SCC of middle ear the increased cell proliferation without a compensatory increase of apoptosis.