【摘要】：目的檢測初發(fā)和復發(fā)尖銳濕疣(CA)患者皮損組織中TRAIL蛋白及其受體DR5、DcRl的表達情況,探討TRAIL介導的細胞凋亡在尖銳濕疣發(fā)病及復發(fā)過程中可能的作用及意義。 材料和方法采用S-P法,即免疫組化過氧化物酶標記鏈酶卵白素法,檢測30例初發(fā)尖銳濕疣患者皮損組織、30例復發(fā)尖銳濕疣患者皮損組織中TRAIL蛋白及其受體DR5、DcRl的表達情況,30例正常皮膚組織作對照組。免疫組化染色結(jié)果采用半定量法判定,所得數(shù)據(jù)運用SPSS17.0統(tǒng)計分析軟件進行統(tǒng)計分析。 結(jié)果1、TRAIL蛋白的免疫陽性產(chǎn)物定位于胞膜和胞漿,多呈棕黃色顆粒狀沉著,陽性細胞主要分布在棘細胞層。TRAIL蛋白在對照組、尖銳濕疣初發(fā)組、尖銳濕疣復發(fā)組的陽性表達率分別為91.67%、83.33%和80.00%,呈遞減趨勢；其表達強度在對照組與尖銳濕疣組間比較,對照組高于尖銳濕疣初發(fā)組和尖銳濕疣復發(fā)組,差異有統(tǒng)計學意義(p0.05),而在尖銳濕疣初發(fā)組和尖銳濕疣復發(fā)組,二者比較無統(tǒng)計學意義(p0.05)。 2、DR5蛋白的免疫陽性產(chǎn)物主要定位于細胞漿,多為淺黃色至棕黃色片狀或彌漫性著色。染色陽性細胞主要分布在基底細胞層和棘細胞層。DR5蛋白在對照組、尖銳濕疣初發(fā)組、尖銳濕疣復發(fā)組的陽性表達率分別是53.33%、83.33%和93.33%,呈遞增趨勢；其表達強度在對照組與尖銳濕疣組間比較,對照組低于尖銳濕疣初發(fā)組和尖銳濕疣復發(fā)組,差異有統(tǒng)計學意義(P0.05)；而在尖銳濕疣初發(fā)組和尖銳濕疣復發(fā)組,二者比較無統(tǒng)計學意義(P0.05)。 3、DcRl蛋白的免疫陽性產(chǎn)物定位于胞漿和胞膜,多為淺黃色至棕黃色片狀或彌漫性著色。染色陽性細胞主要分布在棘細胞層。DcR1蛋白在對照組、尖銳濕疣初發(fā)組、尖銳濕疣復發(fā)組的陽性表達率分別100%、57.50%、40.00%。呈遞減趨勢。其表達強度在任兩組間比較差異均有統(tǒng)計學意義(P0.05)。 結(jié)論 1、TRAIL在尖銳濕疣皮損組織中的異常低表達,可能與尖銳濕疣的發(fā)病有關(guān)。 2、TRAIL在初發(fā)組和復發(fā)組表達率無差異,提示TRAIL可能不是參與尖銳濕疣復發(fā)的主要原因。 3、死亡受體DR5在尖銳濕疣組織中表達上調(diào),可能為外源性TRAIL應(yīng)用于臨床治療提供依據(jù)。 4、誘騙受體DcRl在CA復發(fā)組表達下調(diào),低于CA初發(fā)組,提示DcRl可能是HPV感染細胞逃避機體免疫監(jiān)視,導致尖銳濕疣復發(fā)的一個原因。 5、誘騙受體DeRl在尖銳濕疣組織中表達下調(diào),結(jié)合死亡受體DR5的表達上調(diào),可能解釋外源性TRAIL靶向性殺傷感染細胞的機制。
[Abstract]:Objective to detect the expression of TRAIL protein and its receptor DR5,DcRl in the lesions of patients with primary and recurrent condyloma acuminatum (CA) and to explore the possible role and significance of TRAIL mediated apoptosis in the pathogenesis and recurrence of condyloma acuminatum. Materials and methods S-P method was used to detect TRAIL protein and its receptor DR5, in 30 cases of primary condyloma acuminatum and 30 cases of recurrent condyloma acuminatum. The expression of DcRl in 30 normal skin tissues as control group. The results of immunohistochemical staining were determined by semi-quantitative method, and the data were analyzed by SPSS17.0 software. Results 1the immunoreactive products of trail protein were located in the cell membrane and cytoplasm. The positive cells were mainly distributed in the layer of spinous cells. TRAIL protein was found in the control group and in the primary condyloma acuminatum group. The positive expression rates of the patients with recurrent condyloma acuminatum were 91.67% and 83.33%, respectively, showing a decreasing trend. Compared with condyloma acuminatum group, the expression intensity of condyloma acuminatum in control group was higher than that in primary condyloma acuminatum group and recurrent condyloma acuminatum group (p0.05), but it was higher in primary condyloma acuminatum group and condyloma acuminatum recurrence group. There was no significant difference between the two groups (p 0.05). 2 the immunopositive products of DR5 protein were mainly located in the cytoplasm, most of them were yellowish to brownish flaky or diffuse staining. The positive expression rates of DR5 protein in control group, primary condyloma acuminatum group and recurrent condyloma acuminatum group were 53.333.33% and 93.33%, respectively. Compared with condyloma acuminatum group, the expression intensity of condyloma acuminatum in control group was lower than that in primary condyloma acuminatum group and recurrent condyloma acuminatum group (P0.05). However, there was no significant difference between the two groups in the primary condyloma acuminatum group and the recurrent condyloma acuminatum group (P0.05). 3The immunoreactive products of DcRl protein were located in the cytoplasm and membrane, and most of them were light yellow to brownish yellow flakes or diffuse staining. The positive expression rates of DcR1 protein in the control group, the primary condyloma acuminatum group and the recurrent condyloma acuminatum group were 100% and 57.50% respectively. Show a decreasing trend. There were significant differences in expression intensity between any two groups (P0.05). Conclusion 1 the abnormal low expression of trail in the lesions of condyloma acuminatum may be related to the pathogenesis of condyloma acuminatum. 2There was no difference in the expression rate of trail between the primary group and the recurrent group, suggesting that TRAIL may not be the main reason for the recurrence of condyloma acuminatum. 3. The expression of death receptor DR5 was up-regulated in condyloma acuminatum, which may provide evidence for the application of exogenous TRAIL in clinical treatment. 4. The expression of decoy receptor DcRl was down-regulated in CA recurrence group, which was lower than that in CA group, suggesting that DcRl might be a reason for HPV infection cells to evade immune surveillance and lead to recurrence of condyloma acuminatum. 5. The expression of decoy receptor DeRl was down-regulated in condyloma acuminatum, and the expression of death receptor DR5 was up-regulated, which might explain the mechanism of exogenous TRAIL targeting killing infected cells.
【學位授予單位】：山東大學
【學位級別】：碩士
【學位授予年份】：2012
【分類號】：R752.53

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