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目的:观察端粒酶催化亚单位(TERT)和癌基因cMyc的表达产物(cMyc蛋白)在中耳胆脂瘤上皮中的表达情况,分析其在胆脂瘤上皮增殖演变过程中的作用。方法:应用SP法和计算机图像分析系统,检测TERT、cMyc蛋白在32例胆脂瘤组织和14例胆脂瘤患者外耳道皮肤中的表达情况,并进行比较。结果:TERT和cMyc蛋白在所有胆脂瘤上皮各层细胞均存在较强表达,外耳道皮肤表达较弱。各组间胆脂瘤上皮各指标平均阳性细胞率和平均吸收度(平均灰度的倒数),均高于外耳道皮肤,差异有统计学意义(P<0.05);皮下结缔组织伴有大量的炎症细胞,如:淋巴细胞、浆细胞、中性粒细胞和巨噬细胞;胆脂瘤上皮中TERT和cMyc蛋白之间存在正相关关系(P<0.01)。结论:TERT和cMyc蛋白在胆脂瘤上皮的表达从不同方面反映了胆脂瘤上皮的过度增生和角化,二者在胆脂瘤的发病过程中有协同作用;上皮下炎症反应可能是角化细胞过度增殖的一个原因。
OBJECTIVE: To investigate the expression of cMyc (cMyc) and telomerase catalytic subunit (cMyc) in the middle ear cholesteatoma epithelium, and to explore its role in the proliferation and progression of cholesteatoma epithelium. Methods: SP and computerized image analysis system were used to detect the expression of TERT and cMyc protein in the external auditory meatus skin of 32 cholesteatoma patients and 14 cholesteatoma patients. RESULTS: The TERT and cMyc proteins were strongly expressed in all layers of cholesteatoma epithelial cells, while the expression of the outer ear canal skin was weak. The average positive cell rate and average absorbance (average gray-scale reciprocal) of each index of cholesteatoma in each group were higher than that of the external auditory meatus (P <0.05). Subcutaneous connective tissue accompanied by a large amount of inflammation Cells such as lymphocytes, plasma cells, neutrophils and macrophages showed a positive correlation between TERT and cMyc proteins in cholesteatoma epithelium (P <0.01). CONCLUSION: The expression of TERT and cMyc in cholesteatoma epithelium reflects the hyperproliferation and keratosis of cholesteatoma epithelium from different aspects. Both of them have synergistic effect in the pathogenesis of cholesteatoma. The subepithelial inflammation may be the angle One of the causes of cell hyperproliferation.