本文選題：盤狀紅斑狼瘡 + 扁平苔癬��； 參考：《廣西醫(yī)科大學》2017年碩士論文

【摘要】：目的初步探討角蛋白K14在盤狀紅斑狼瘡與扁平苔癬皮損中表達的差異及臨床意義。方法選取廣西醫(yī)科大學第一附屬醫(yī)院皮膚科石蠟包埋的盤狀紅斑狼瘡組織20例、扁平苔癬20例為研究對象;以整形美容外科手術后正常皮膚組織10例作為對照,角蛋白K14在扁平苔癬、盤狀紅斑狼瘡、正常人表皮中的表達采用SP免疫組化方法。對表達結果同時采用人工測評半定量法判定,以及Image-Pro Plus 6.0數碼醫(yī)學圖像分析系統(tǒng)進行平均光密度定量測定;對兩種方法所得結果采用SPSS 17.0軟件進行秩和檢驗和t檢驗等統(tǒng)計方法,P0.05表示差異有統(tǒng)計學意義。結果1.角蛋白K14在全層表達:正常皮膚組10例在基底層或棘層下部均呈陽性表達,20例DLE組和20例LP組全層均有表達,但DLE組陽性表達主要集中在棘層中部以下,LP組全層表達較均勻,3組間兩兩比較,均P0.05,差異均有統(tǒng)計學意義。2.角蛋白K14在基底層的表達:20例DLE組中,2例呈弱陽性,余下18例呈陽性表達;LP組、正常皮膚組織中均呈陽性表達,3組間兩兩比較,均P0.05,差異均無統(tǒng)計學意義。3.角蛋白K14在棘層下部表達:DLE組20例、LP組20例均呈陽性或強陽性表達,而10例正常皮膚組織僅有3例呈陽性表達;陽性表達主要位于角質形成細胞胞漿;實驗組與對照組比較,均P0.05,兩者間差異有統(tǒng)計學意義;而兩實驗組相互比較,P0.05,差異無統(tǒng)計學意義。4.角蛋白K14在棘層中部表達:DLE組中2例無表達,余下18例呈陽性或強陽性表達,LP組全部呈強陽性表達,正常皮膚組無表達;陽性表達主要位于角質形成細胞胞漿;3組兩兩比較,均P0.05,差異有統(tǒng)計學意義。5.角蛋白K14在棘層上部表達:DLE組中6例無表達,余下14例呈強陽性或極強陽性表達;LP組全部呈強陽性或極強陽性表達,正常皮膚組無表達;陽性表達主要位于角質形成細胞胞漿;3組兩兩比較,均P0.05,差異有統(tǒng)計學意義。結論1.角蛋白K14在LP和DLE組表達增強,提示角蛋白K14可能在一定程度上參與兩者的發(fā)生發(fā)展。2.角蛋白K14在LP和DLE組棘層中部及棘層上部表達存在差異,提示其在兩者角質形成細胞后期的增殖及分化中的調控作用可能存在差異,確切機制有待進一步研究。3.LP組較DLE組角蛋白K14表達更強,尤其是在棘層上部呈相對強陽性表達時,有可能成為兩者鑒別診斷的有用參考指標。
[Abstract]:Objective to investigate the difference and clinical significance of keratin K 14 expression in the lesions of lupus platensis and lichen planus. Methods Twenty cases of discoid lupus erythematosus and 20 cases of lichen planus were selected from dermatology department of the first affiliated Hospital of Guangxi Medical University, and 10 cases of normal skin tissue after plastic surgery were used as control. The expression of keratin K14 in the epidermis of lichen planus, discoid lupus erythematosus and normal human epidermis was detected by SP immunohistochemical method. At the same time, the expression results were determined by artificial semi-quantitative method and by Image-Pro Plus 6.0 digital medical image analysis system for quantitative measurement of average optical density. There was significant difference between the two methods by using SPSS 17.0 software for rank sum test and t test. Result 1. The expression of keratin K14 in the whole layer: the positive expression of keratin K14 was found in 10 cases of normal skin group and 20 cases of DLE group and 20 cases of LP group. But the positive expression of DLE group was mainly concentrated in the whole layer of LP group below the middle part of spinous layer, which was more uniform than that of the control group (P0.05), and the difference was statistically significant (P < 0.05). The expression of keratin K14 in the basal layer of 20 cases of DLE was weakly positive in 2 cases, and in the other 18 cases of positive expression in LP group. The positive expression of keratin K14 in normal skin tissue was significantly higher than that in control group (P0.05, P 0.05), and there was no significant difference between the three groups (P < 0.05). The expression of keratin K14 was positive or strongly positive in 20 cases of LP group and only 3 cases of normal skin tissue in 10 cases, the positive expression was mainly located in cytoplasm of keratinocytes, and the positive expression of keratin K14 was mainly in cytoplasm of keratinocytes in the control group, compared with the control group, the positive expression of keratin K14 was found in the cytoplasm of keratinocytes. The difference between the two groups was statistically significant, while there was no significant difference between the two experimental groups. Keratin K14 was expressed in the middle of the spinous layer in 2 cases without expression, the remaining 18 cases showed strong positive expression in LP group and normal skin group, and the positive expression was mainly in cytoplasmic cytoplasm of keratinocytes. The difference was statistically significant. There was no expression of keratin K14 in the upper part of the spinous layer in 6 cases, while in the other 14 cases, it was strongly positive or very strong positive in LP group, and no expression was found in normal skin group. The positive expression was mainly located in cytoplasm of keratinocytes (P 0.05). Conclusion 1. The expression of keratin K14 was enhanced in LP and DLE groups, suggesting that keratin K14 might be involved in the occurrence and development of keratin K14 to some extent. There were differences in the expression of keratin K14 between LP and DLE groups in the middle and upper part of the spinous layer, which suggested that K14 might play a different role in the proliferation and differentiation of keratinocytes. The exact mechanism of keratin K14 expression in LP group is higher than that in DLE group, especially in the upper part of spinous layer, which may be a useful reference index for differential diagnosis.
【學位授予單位】：廣西醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R758.6

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