多点穿刺D2-40、CD31、CD34免疫组织化学染色在卡波西样血管内皮瘤原位植皮术中的应用  

The application of multi-point puncture D2-40, CD31, CD34 staining for autologous skin graftingin Kaposiform hemangioendothelioma

作　　者：孙龙龙 孙斌 邢亚萍 马玉春 雷红召 李森森 董长宪 Sun Longlong;Sun Bin;Xing Yaping;Ma Yuchun;Lei Hongzhao;Li Miaomiao;Dong Changxian(Department of Hemangioma Surgery in People's Hospital of Zhengzhou University and Henan Provincial People's Hospital,Zhengzhou 450000,China;Department of Pathology in Henan Provincial People's Hospital,Zhengzhou 450000,China)

机构地区：[1]郑州大学人民医院血管瘤科,河南省人民医院血管瘤科,450000 [2]河南省人民医院病理科,郑州450000

出　　处：《中华整形外科杂志》2019年第11期1102-1106,共5页Chinese Journal of Plastic Surgery

基　　金：河南省医学科技攻关项目(201403152)。

摘　　要：目的探讨卡波西样血管内皮瘤术前行多点病理穿刺,确定其侵袭范围,以选择手术方式的可行性。方法2013年7月至2016年4月郑州大学人民医院收治卡波西样血管内皮瘤患者17例,男7例,女10例,首诊年龄(75.60±31.55)do术前行多点病理穿刺D2-40、CD31、CD34免疫组织化学染色,确定卡波西样血管内皮瘤对皮肤的侵袭范围,以判定术中是否行原位植皮术。术后观察植皮成活面积,分别于1、4、12、24周检测血小板值。结果本组17例,15例表皮及真皮乳头层未受侵犯行原位植皮术,2例因瘤体侵犯皮下组织浅层行皮片移植修补术。15例行原位植皮术的患者,术后1周血小板恢复正常,第4、12、24周血小板均高于100x109/L;12例成活面积大于90%,2例成活面积为70%~90%,1例约为50%。结论在卡波西样血管内皮瘤完全切除术中,术前行D2・40、CD31、CD34穿刺染色确定瘤体对皮肤侵袭范围,可最大限度保留瘤体表面正常皮肤,降低术后并发症,是一种多学科联合的方式。Objective To explore the feasibility of application of multi-point punctureimmunohistochemical to determine the invasion extent of the epidermis in Kaposiform hemangioendotheliomabefore surgery and choose the surgical method. Methods From July 2013 to April 2016, 17 patients withKaposiform hemangioendothelioma were admitted to the People' s Hospital of Zhengzhou University,including 7 males and 10 females. The first consultation age was 75. 60±31. 55 days. Preoperative multipointpathological puncture D2-40, CD31, CD34 immunohistochemical staining was to test the invasionextent of the epidermis in Kaposiform hemangioendothelioma and to determine whether undergo autologousskin grafting. Skin graft survival areas were recorded postoperatively. Platelet values were examined after1 week, 4 weeks, 12 weeks and 24 weeks. Results In these 17 cases, 15 cases with epidermis anddermis unaffected was performed in situ grafting. 2 cases with the tumor invasion, superficial skin graftingwere repaired. In these 15 cases of in situ grafting, platelet values returned to normal at 1 week after theoperations, and platelet values were higher than 100x 109/L at 4 weeks, 12 weeks and 24 weeks. Among them, 12 cases of epidermal survival area were greater than 90% , 2 cases were 70% -90% , and 1 caseswas about 50%. Conclusions During the complete resection of Kaposiform hemangioendothelioma, themulti-puncture D2-40, CD31 and CD34 staining are used to determine invasion extent of the tumor to theskin, which can maximize the retention of normal tissue surface, reduce postoperative complications. This isa new multi-disciplinary surgical approach.

关 键 词：卡波西样血管内皮瘤 原位植皮术 免疫组织化学 

分 类 号：R73[医药卫生—肿瘤]