不同顏色分型鮮紅斑痣畸形血管的形態(tài)學初步研究
發(fā)布時間：2018-09-17 12:29
【摘要】： 目的： 通過對不同顏色分型的鮮紅斑痣病理標本進行HE染色及免疫組織化學檢查,光鏡下觀察不同分型鮮紅斑痣的組織病理變化,對病理圖像進行計算機分析,測量不同顏色分型鮮紅斑痣畸形血管的平均血管直徑、平均血管深度、最大血管深度、數(shù)密度等血管參數(shù),探討不同臨床表現(xiàn)鮮紅斑痣畸形血管的形態(tài)學差異,以期指導臨床治療時采用不同的激光參數(shù),提高治療效果。 方法： 2008年3月~2009年3月在我科門診就診的鮮紅斑痣病人中,將兩名以上主治醫(yī)師肉眼觀察結(jié)果與CM-2600d分光測色儀測到的a*值相結(jié)合,據(jù)此對所有患者按病灶區(qū)顏色不同分為四型：粉紅型(I型)、鮮紅型(II型)、紫紅型(Ⅲ型)及紫紅伴結(jié)節(jié)或增厚型(Ⅳ型)。每型隨機選擇10例,均未做任何治療,病灶全部位于面部或頸部。另在40例患者中隨機選取10例病灶對側(cè)面頸部正常皮膚組織。2%利多卡因局部麻醉后,用手術(shù)刀垂直于病灶采集病灶區(qū)組織及正常皮膚組織,常規(guī)固定包埋,切片后行HE染色及Ⅷ因子免疫組織化學染色標記血管。HE染色切片在光鏡下觀察組織病理,重點觀察畸形血管。免疫組化染色切片行計算機圖像分析處理,測量以下血管參數(shù)：平均血管直徑、平均血管深度、最大血管深度,并根據(jù)體視學原理計算出數(shù)密度。各組數(shù)據(jù)以(x±s)表示,用SPSS16.0軟件包進行統(tǒng)計,性別構(gòu)成檢驗選用精確概率法,年齡構(gòu)成檢驗選用秩和檢驗,多組均數(shù)比較采用完全隨機設計資料單因素方差分析,P0.05為差異有統(tǒng)計學意義。 結(jié)果： 組織學檢查：HE染色可見表皮層正常,真皮淺層毛細血管呈群集擴張狀。隨著病變顏色加深,血管數(shù)目增多,直徑增大,部分擴張毛細血管延及真皮深層和皮下組織,含紅細胞充盈的毛細血管增多：內(nèi)皮細胞成熟但不增生。免疫組化檢查：Ⅷ因子標記的血管陽性染色示真皮淺、中層可見大量染色呈棕褐色的毛細血管.大部分呈擴張畸形。計算機圖像分析：粉紅型、鮮紅型、紫紅型及結(jié)節(jié)增厚型PWS實驗組擴張毛細血管的直徑(μm)分別為：55.39±2.74、94.55±2.13、133.85±11.51、171.07±13.75；最大毛細血管深度(mm)分別為：0.51±0.07、0.61±0.16、0.72±0.11、0.87±0.18：平均毛細血管深度(mm)分別為：0.40±0.10、0.43±0.21、0.52±0.08、0.62±0.12；數(shù)密度(／mm2)分別為：15.87±0.07、19.14±1.09、22.39±3.10、25.33±2.84。正常對照組的毛細血管直徑(μm)為14.23±0.85、最大毛細血管深度(m)為0.51±0.17、平均毛細血管深度(mm)為0.40±0.14、數(shù)密度(／mm2)為6.70±0.34。其中平均血管直徑和數(shù)密度在不同臨床表現(xiàn)組有顯著性差異：正常組與粉紅組的最大血管深度,正常組與粉紅組、正常組與鮮紅組以及粉紅組與鮮紅組的平均血管深度無統(tǒng)計學差異,其它各臨床表現(xiàn)組之間均有顯著性差異。 結(jié)論： 隨著鮮紅斑痣病灶區(qū)顏色加深,患者年齡逐漸增大,病灶區(qū)血管直徑、數(shù)密度、最大深度,平均深度亦逐漸增加；粉紅型和鮮紅型PWS病灶區(qū)血管分布位置較淺,主要表現(xiàn)為血管擴張和數(shù)目增多；紫紅型和結(jié)節(jié)增厚型PWS病灶區(qū)血管分布位置較深,血管擴張明顯,單位空間內(nèi)血管數(shù)目增多。隨著病灶區(qū)顏色加深,臨床激光治療時可選擇不同波長的激光器,適當增加脈寬和能量密度等。
[Abstract]:Objective:
By HE staining and immunohistochemical examination on pathological specimens of different color types of nevus flammeus, the histopathological changes of different types of nevus flammeus were observed under light microscope, and the pathological images were analyzed by computer. The mean vessel diameter, average vessel depth and maximum vessel depth of different color types of nevus flammeus were measured. To explore the morphological differences of vascular deformities in different clinical manifestations of port wine stain, and to guide the clinical treatment with different laser parameters, so as to improve the therapeutic effect.
Method:
From March 2008 to March 2009, two or more physicians attending the outpatient department of our department combined naked eye observation with a * value measured by CM-2600d spectrophotometer. All patients were divided into four types according to the color of lesion area: pink (type I), bright red (type II), purple red (type II I) and purple red with nodules or enlargement. Thick type (type IV). Each type was randomly selected in 10 patients without any treatment, and the lesions were all located in the face or neck. Another 40 patients were randomly selected 10 lesions on the side and neck of normal skin tissue. After local anesthesia with 2% lidocaine, the lesions were collected with scalpel perpendicular to the lesion area and normal skin tissue, routinely fixed and embedded, and sectioned. HE staining and factor_immunohistochemical staining were used to label the vessels.HE staining sections were used to observe the histopathology under the light microscope with emphasis on the observation of malformed vessels.Immunohistochemical staining sections were used for computer image analysis.The following vascular parameters were measured: mean vessel diameter, mean vessel depth and maximum vessel depth. The data of each group were expressed as (x 65507
Result:
Histological examination: HE staining showed that the epidermis was normal and the capillaries in the superficial dermis were clustered and dilated. With the deepening of the lesion color, the number and diameter of the capillaries increased. Some dilated capillaries extended to the deep dermis and subcutaneous tissues. The capillaries filled with red blood cells increased. _factor labeled vascular positive staining showed that the dermis was light and a large number of brown capillaries were seen in the middle layer. Most of them were dilated deformities. The maximum capillary depth (mm) were 0.51 (+ 0.07), 0.61 (+ 0.16), 0.72 (+ 0.11), 0.87 (+ 0.18) and the mean capillary depth (mm) were 0.40 (+ 0.10), 0.43 (+ 0.21), 0.52 (+ 0.08), 0.62 (+ 0.12), and the number density (/ mm2) were 15.87 (+ 0.07), 19.14 (+ 1.09), 22.39 (+ 3.10) and 25.33 (+ 2.84) in the control group, respectively. M) was 14.23 [0.85], the maximum capillary depth (m) was 0.51 [0.17], the average capillary depth (m m) was 0.40 [0.14], and the numerical density (/ mm2) was 6.70 [0.34]. There were significant differences in the mean diameter and density of blood vessels between the normal group and the pink group, the normal group and the pink group, the normal group and the bright red group. There was no significant difference in the mean vascular depth between the pink group and the bright red group.
Conclusion:
With the deepening of the color of the lesion area, the age of the patients gradually increased, and the diameter, number density, maximum depth and average depth of the lesion area also gradually increased; the distribution of the blood vessels in the lesion area of pink and bright red PWS was shallow, mainly manifested by the expansion and increase of the number of blood vessels; the distribution of blood vessels in the lesion area of purple and nodular thickening PWS With the darkening of the color of the lesion area, different wavelengths of laser can be selected for clinical treatment, and pulse width and energy density can be increased appropriately.
【學位授予單位】：廣州中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2010
【分類號】：R758.51
本文編號：2245926
[Abstract]:Objective:
By HE staining and immunohistochemical examination on pathological specimens of different color types of nevus flammeus, the histopathological changes of different types of nevus flammeus were observed under light microscope, and the pathological images were analyzed by computer. The mean vessel diameter, average vessel depth and maximum vessel depth of different color types of nevus flammeus were measured. To explore the morphological differences of vascular deformities in different clinical manifestations of port wine stain, and to guide the clinical treatment with different laser parameters, so as to improve the therapeutic effect.
Method:
From March 2008 to March 2009, two or more physicians attending the outpatient department of our department combined naked eye observation with a * value measured by CM-2600d spectrophotometer. All patients were divided into four types according to the color of lesion area: pink (type I), bright red (type II), purple red (type II I) and purple red with nodules or enlargement. Thick type (type IV). Each type was randomly selected in 10 patients without any treatment, and the lesions were all located in the face or neck. Another 40 patients were randomly selected 10 lesions on the side and neck of normal skin tissue. After local anesthesia with 2% lidocaine, the lesions were collected with scalpel perpendicular to the lesion area and normal skin tissue, routinely fixed and embedded, and sectioned. HE staining and factor_immunohistochemical staining were used to label the vessels.HE staining sections were used to observe the histopathology under the light microscope with emphasis on the observation of malformed vessels.Immunohistochemical staining sections were used for computer image analysis.The following vascular parameters were measured: mean vessel diameter, mean vessel depth and maximum vessel depth. The data of each group were expressed as (x 65507
Result:
Histological examination: HE staining showed that the epidermis was normal and the capillaries in the superficial dermis were clustered and dilated. With the deepening of the lesion color, the number and diameter of the capillaries increased. Some dilated capillaries extended to the deep dermis and subcutaneous tissues. The capillaries filled with red blood cells increased. _factor labeled vascular positive staining showed that the dermis was light and a large number of brown capillaries were seen in the middle layer. Most of them were dilated deformities. The maximum capillary depth (mm) were 0.51 (+ 0.07), 0.61 (+ 0.16), 0.72 (+ 0.11), 0.87 (+ 0.18) and the mean capillary depth (mm) were 0.40 (+ 0.10), 0.43 (+ 0.21), 0.52 (+ 0.08), 0.62 (+ 0.12), and the number density (/ mm2) were 15.87 (+ 0.07), 19.14 (+ 1.09), 22.39 (+ 3.10) and 25.33 (+ 2.84) in the control group, respectively. M) was 14.23 [0.85], the maximum capillary depth (m) was 0.51 [0.17], the average capillary depth (m m) was 0.40 [0.14], and the numerical density (/ mm2) was 6.70 [0.34]. There were significant differences in the mean diameter and density of blood vessels between the normal group and the pink group, the normal group and the pink group, the normal group and the bright red group. There was no significant difference in the mean vascular depth between the pink group and the bright red group.
Conclusion:
With the deepening of the color of the lesion area, the age of the patients gradually increased, and the diameter, number density, maximum depth and average depth of the lesion area also gradually increased; the distribution of the blood vessels in the lesion area of pink and bright red PWS was shallow, mainly manifested by the expansion and increase of the number of blood vessels; the distribution of blood vessels in the lesion area of purple and nodular thickening PWS With the darkening of the color of the lesion area, different wavelengths of laser can be selected for clinical treatment, and pulse width and energy density can be increased appropriately.
【學位授予單位】：廣州中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2010
【分類號】：R758.51
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