Expression for Proliferating Cell Nuclear Antigen in Cholesteatoma Epithelia

背景：增殖細胞核抗原因proliferating cell nuclear antigen, PCNA), 是一種在細胞中生殖週期中G1後期和S期合成的一種核蛋白，其出現陽性細胞的多寡細胞的增殖活性有密切的正相關。它近年來常被利用作為評估腫瘤和其病理組織分類、臨床預後之相關因子。中耳膽脂瘤之組織在病理上，是很類似皮膚的構造，但在臨床上卻是具有相當的侵蝕性，在中耳腔中，它會對聽小骨及乳突骨液生嚴重的破壞，名稱上，他雖然被稱為”腫瘤”，但事實上有相關之文獻報告認為它不是一種真正的腫瘤組織；本有嘗試利用PCNA 來分析探討慢性中耳炎之有關膽脂瘤和鼓膜上皮組織細胞之增值活性。方法：利用免疫組織化學酵素抗體法(avidin-biotin-peroxidase complex; ABC method) 以PCNA單株抗體免疫染色，在顯微鏡下觀察比較37例慢性中耳炎合併膽脂瘤和7例慢性中耳炎之鼓膜上皮細胞內之PCNA 陽性細胞之分布表現，免疫組織化學染色以?扁桃組織作為陽性對照。結果：在37例(平均年齡37歲)中耳膽脂瘤上皮組織中，PCNA陽性分布百分比在basal layer, parabasal layer, upper layer 分別為78% (29例)、68%(25例)及41%(15例)；而7例(平均年齡34歲)之鼓膜上皮組織中，PCNA陽性分佈百分比由下而上依序分別為86%(6例)，71%(5例)，43%(3例)；另外21例(平均年齡39歲)正常耳廓後皮膚上皮細胞中PCNA陽性百分比依序分別為71%(15例)，67%(14例)及34%(7例)，3組中之任兩組之PCNA陽性分佈表現，依卡方法檢定結果，並沒有統計上差異。結論：雖然慢性中耳炎之膽脂瘤和鼓膜上皮細胞中，PCNA陽性細胞出現率正常耳廓後皮膚高，但利用卡方檢定3組之PCNA陽性細胞出現的百分比，並無統計學上之差異；換言之，慢性中耳炎之膽脂瘤和鼓膜上皮細胞之增殖活性雖然較正常耳廓後皮膚高，也許是受到上皮細胞下組織發炎的影響。

關鍵字

膽脂瘤；增值細胞核抗原；鼓膜；慢性中耳炎；免疫組織化學

並列摘要

BACKGROUND: The clinical characteristics of cholesteatomas, namely invasion, migration, altered differentiation, aggressiveness, and easy recurrence, are traits typically associated with the neoplastic cells. Using the proliferating cell nuclear antigen (PCNA) immunohistochemical staining method, we attempted to compare the proliferative features of human middle ear cholesteatoma with tympanic membrane of chronic otitis media (COM) and normal postauricular skin and to delineate the possible role of this immunohistochemical staining method in assessing the middle ear cholesteatoma. METHODS: We used ABC (avidin-biotin complex) technique and monoclonal antibody to PCNA to evaluate the expression of PCNA in 37 cases of cholesteatoma epithelium, 7 cases of tympanic membrane of chronic otitis media, and 21 cases of normal postauricular skin. RESULTS: The PCNA-positive cell rate in basal, parabasal, and upper layer of each cholesteatoma epithelium tissue was 78%, 68%, and 41% respectively. In the epithelium of the tympanic membrane, PCNA-positive cell rate in basal, parabasal, and upper layer was 86%, 71%, and 43% respectively. The PCNA-positive cell rate in normal postauricular skin tissue was 71%, 67%, and 34% respectively. The results of this report indicate that the proliferative activity in cholesteatoma is similar to that of the tympanic membrane of chronic otitis media and normal postauricular skin (P＞0.05). CONCLUSION: we found that cholesteatoma and tympanic membrane have a higher PCNA-positive cell rate than normal postauricular skin, but no statistical significance was observed among the epithelium layer. We conclude that despite its clinical behavior, which is similar to neoplastic cells, cholesteatoma itself is not a real tumor.

並列關鍵字

cholesteatoma ； proliferating cell nuclear antigen (PCNA) ； tympanic membrane ； chronic otitis media ； immunohistochemistry

國際替代計量

Expression for Proliferating Cell Nuclear Antigen in Cholesteatoma Epithelia

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