皮肤扩张后表皮干细胞异位现象初步研究  

Preliminary study on the phenomenon of epidermal stem cell ectopy in expanded skin

作　　者：刘虎仙[1] 田孝臣[1] 贾赤宇[2] 吕晓杰[1] 李桂水[1] 

机构地区：[1]解放军第二炮兵总医院烧伤整形科,北京100088 [2]解放军总医院第一附属医院全军烧伤研究所

出　　处：《中华烧伤杂志》2009年第6期437-440,共4页Chinese Journal of Burns

摘　　要：目的了解皮肤软组织扩张术后表皮干细胞（ESC）的分化和分布情况，初步探讨扩张皮肤组织的相关生长机制。方法取15例行Ⅱ期头、颈部皮肤扩张术患者扩张后（平均注水期45d）皮肤标本及正常皮肤标本，按取材部位分为：（1）头部近扩张器中心组：取与扩张器中轴线垂直距离为3cm处的扩张后头皮；（2）头部扩张器侧壁组：取与扩张器中轴线垂直距离为5-7cm的扩张后头皮；（3）颈部扩张皮肤组；（4）未扩张头皮对照组；（5）未扩张颈部皮肤对照组。各组皮肤标本行HE染色观察组织结构，行免疫组织化学染色观察细胞角蛋白19（CK19）阳性细胞的分化及分布特征。结果与2个未扩张对照组比较，HE染色可见各扩张组表皮层凹凸不平且相对增厚，皱褶明显，细胞层次增多；细胞呈密集分布，以靠近基底层最为显著，但排列欠整齐，极性过度不明显。免疫组织化学染色显示，各扩张组基底层CK19阳性细胞的连续性基本存在，基底层个别部位阳性细胞明显增多，呈复层排列；基底层之外亦有少量成团或散在分布的CK19阳性细胞。2个未扩张对照组未见上述现象。结论皮肤软组织扩张后，ESC在修复过程中增殖和分化加强，并出现异位分布。Objective To observe the differentiation and distribution of epidermal stem cell （ESC） after skin soft tissue expansion, and to initially probe into the growth mechanism of expanded skin tissue. Methods Samples of normal skin and expanded skin （mean affusion period 45 days） were harvested from head and cervical region in 15 patients who underwent Ⅱ stage surgery after skin expansion. Samples were divided into scalp adjacent to the center of expander group （expanded scalp, 3cm from the vertical axis of the expander） , scalp from lateral part of the expander group （ expanded scalp, 5-7 cm lateral to the vertical axis of the expander）, cervical skin expansion group, un-expanded scalp control group, and un-expanded cervical skin control group, according to the position of skin harvested. The tissue structure of skin in each group was observed with HE staining, and the differentiation and distribution characteristics of cytokeratin 19 （CK19） positive cells were observed with immunohistochemical staining. Results Compared with those in the un-expanded control groups, uneven, relatively thickened and obviously folded epidermis with more cell layers and cells with obvious aggregation close to the basal layer were observed in the expanded groups, but those ceils were not well-arranged and the transition of polarity was not obvious. The continuity of CK19 positive cells in the basal layer of skin was observed in each of the expanded group with immunohistochemical staining, and positive ceils increased obviously and arranged in muhilayer in certain parts of basal layer. Clustered or dispersed CK19 positive cells were also observed outside the basal layer. No above-mentioned phenomenon was observed in the un-expanded control group. Conclusions The proliferation and differentiation of ESC with ectopic distribution may enhance the repair process after skin soft tissue expansion.

关 键 词：皮肤 扩张术 表皮干细胞 创面修复 

分 类 号：R686[医药卫生—骨科学]