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目的观察光动力疗法(PDT)对尖锐湿疣(CA)患者皮损中朗格汉斯细胞(LC)的影响,进一步探寻PDT治疗CA的免疫机制。方法应用免疫组化标记方法,对15例PDT治疗前后的CA皮损及5例正常包皮组织对照进行染色,在高倍光镜下观察LC的形态、分布及数量等的变化。结果 15例CA皮损较正常对照组织[(18.8±4.0)个/高倍视野]LC数量明显降低(P<0.01),表皮内LC分布不规则,大部分LC结构不完整,细胞突减少、缩短甚至消失,缺少LC的典型特征,点状或条索状。个别皮损表皮内LC缺失,而其真皮内见到不典型的LC。PDT治疗后即刻组LC数量[(9.2±2.0)个/高倍视野]较治疗前组[(6.2±1.8)个/高倍视野]明显升高(P<0.05),治疗后7 d组LC数量[(6.4±1.1)个/高倍视野]回落接近治疗前水平(P>0.05),差异无统计学意义。结论 CA患者皮损局部细胞免疫功能低下,作为抗原提呈细胞的LC,其数量和形态发生改变。PDT能诱导CA皮损局部LC数量及形态发生明显改变,具有调节局部免疫的作用。
Objective To observe the effect of photodynamic therapy (PDT) on Langerhans cells (LC) in the lesions of patients with condyloma acuminatum (CA) and further explore the immune mechanism of PDT in the treatment of CA. Methods Immunohistochemical staining method was used to stain the CA lesions of 15 cases of PDT before and after treatment and 5 cases of normal foreskin tissue. The morphology, distribution and quantity of LC were observed under high light microscope. Results The number of LC lesions in 15 cases of CA lesions was significantly lower than that in normal control tissues (18.8 ± 4.0) / high power field (P <0.01). The distribution of LC in the epidermis was irregular, most of the LC structures were incomplete, Even disappear, the lack of the typical features of LC, punctate or cords. Individual lesions within the epidermis of the LC is missing, and the dermis to see atypical LC. The number of LC immediately after PDT was significantly higher than that before treatment [(9.2 ± 2.0) / high power fields [(6.2 ± 1.8) / high power fields) (P < (6.4 ± 1.1) / high power field], and the difference was not statistically significant (P> 0.05). Conclusion The local cellular immunity in CA lesions is low, and the quantity and morphology of LC as antigen-presenting cells are changed. PDT induced CA lesions in local LC number and morphological changes significantly, with the role of local immune regulation.