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目的:研究表皮生长因子受体(EGFR)、Ki67、p16在成人中耳继发性胆脂瘤上皮中的表达情况,分析它们之间的相互关系,探讨其表达对胆脂瘤上皮侵袭能力的影响。方法:应用免疫组织化学SP染色方法检测EGFR、Ki67和p16在30例成人中耳胆脂瘤上皮、21例成人胆脂瘤患者外耳道正常皮肤、17例正常人外耳道中的表达情况,应用计算机图像分析系统对其阳性表达进行定量分析。结果:EGFR、Ki67、p16在成人中耳继发性胆脂瘤上皮中阳性表达率分别为70.0%,60.0%,46.7%,与外耳道正常皮肤相比表达均差异有统计学意义。成人中耳胆脂瘤中EGFR、Ki67与p16之间表达均无相关性(均P>0.05)。胆脂瘤侵袭能力与EGFR、Ki67表达有显著相关性(均P<0.01)。EGFR、Ki67表达灰度值越低,表达密度越高,胆脂瘤侵袭能力越强。p16在成人中耳胆脂瘤中的表达与侵袭能力之间无相关性(P>0.05)。EGFR、Ki67、p16在成人中耳胆脂瘤中阳性细胞主要分布于上皮全层,以基底层和棘层为著,呈高度表达;而在对照组中阳性细胞仅在基底层表达,呈弱表达。结论:EGFR、Ki67、p16在成人中耳胆脂瘤中呈高表达,EGFR、Ki67的表达与成人中耳胆脂瘤的侵袭能力有高度相关性,提示成人中耳胆脂瘤具有高度增殖能力,其中细胞因子EGFR、Ki67、p16起到重要的作用。
OBJECTIVE: To study the expression of epidermal growth factor receptor (EGFR), Ki67 and p16 in the secondary middle ear cholesteatoma epithelium of adult patients, and to explore the relationship between the expression of epidermal growth factor receptor (EGFR) influences. Methods: Immunohistochemical SP staining was used to detect the expression of EGFR, Ki67 and p16 in 30 cases of adult middle ear cholesteatoma epithelium and 21 cases of adult cholesteatoma patients with normal external auditory canal and 17 cases of normal human ear canal. The computer image Analysis system quantitative analysis of its positive expression. Results: The positive rates of EGFR, Ki67 and p16 were 70.0%, 60.0% and 46.7% in adult middle ear secondary cholesteatoma epithelium, respectively, which were significantly different from those of normal skin of external auditory canal. There was no correlation between the expression of EGFR, Ki67 and p16 in adult middle ear cholesteatoma (all P> 0.05). There was a significant correlation between the invasion ability of cholesteatoma and the expression of EGFR and Ki67 (all P <0.01). The lower the gray value of EGFR, Ki67 expression, the higher the expression density, the stronger the ability of invasion of cholesteatoma. There was no correlation between the expression of p16 and invasive ability in middle ear cholesteatoma (P> 0.05). The positive cells of EGFR, Ki67 and p16 in adult middle ear cholesteatoma were mainly distributed in the whole epithelial layer, and were highly expressed in the basal layer and the stratum spinosum. In the control group, the positive cells were only expressed in the basal layer and were weak expression. Conclusion: EGFR, Ki67 and p16 are highly expressed in adult middle ear cholesteatoma. The expression of EGFR and Ki67 is highly correlated with the invasive ability of adult middle ear cholesteatoma, suggesting that adult middle ear cholesteatoma has a high proliferative capacity Among them, cytokines EGFR, Ki67, p16 play an important role.