Işık Özgür, Karlıdağ Turgut, Şimşek Bengü Çobanoğlu, Keleş Erol, Kaygusuz İrfan, Yalçın Şinasi, Orhan İsrafil, Sapmaz Emrah
Department of Otorhinolaryngology, Fırat University Faculty of Medicine, Elazığ, Turkey.
Department of Pathology, Fırat University Faculty of Medicine, Elazığ, Turkey.
Turk Arch Otorhinolaryngol. 2015 Jun;53(2):55-61. doi: 10.5152/tao.2015.1159. Epub 2015 Jun 1.
The aim of this study was to evaluate bcl-2, bax, and c-erbB-2 expressions in primary and secondary acquired cholesteatoma and to indicate the role of apoptosis and accompanying increased cellular proliferation in the pathogenesis of cholesteatoma.
Samples obtained from the skin of the external ear canal (EEC) of patients operated for chronic otitis media (COM) without cholesteatoma constituted Group 1; samples from the EEC skin of patients in Group 3 operated for COM with cholesteatoma and from the EEC skin of patients in Group 4 constituted Group 2; samples obtained from the cholesteatoma matrix of patients operated for COM with primary acquired cholesteatoma constituted Group 3; and samples obtained from the cholesteatoma matrix of patients operated for COM with secondary acquired cholesteatoma constituted Group 4. The assessment of the positive cell ratio was based on the presence of the following findings and was semiquantitatively classified into four groups: 0, no staining; + cell staining (weak positive staining: 1%-33%); ++ cell staining (moderately positive staining: 34%-66%); and +++ cell staining (strong positive staining: 67%-100%).
Comparison of the staining scores of bcl-2, bax, and c-erbB-2 revealed a statistically insignificant difference in the staining of samples obtained from the EEC skin (p>0.05). Decreased bcl-2 expression and increased bax and c-erbB-2 expressions were determined in primary and secondary acquired cholesteatoma epithelium compared with the EEC skin of patients operated for COM with or without cholesteatoma, and the differences were found to be statistically significant (p<0.05).
In acquired cholesteatoma epithelium, the finding of decreased bcl-2 expression as well as increased bax and c-erbB-2 expressions compared with the EEC skin is an indicator of the increase in both cellular proliferation and apoptosis.
本研究旨在评估原发性和继发性获得性胆脂瘤中bcl-2、bax和c-erbB-2的表达情况，并阐明细胞凋亡及伴随的细胞增殖增加在胆脂瘤发病机制中的作用。
从接受慢性中耳炎（COM）手术但无胆脂瘤患者的外耳道（EEC）皮肤获取的样本构成第1组；第3组接受COM伴胆脂瘤手术患者的EEC皮肤样本和第4组患者的EEC皮肤样本构成第组；从接受原发性获得性胆脂瘤的COM手术患者的胆脂瘤基质中获取的样本构成第3组；从接受继发性获得性胆脂瘤的COM手术患者的胆脂瘤基质中获取的样本构成第4组。阳性细胞比例的评估基于以下结果，并进行半定量分类为四组：0，无染色；+细胞染色（弱阳性染色：1%-33%）；++细胞染色（中度阳性染色：34%-66%）；+++细胞染色（强阳性染色：67%-100%）。
bcl-2、bax和c-erbB-2的染色评分比较显示，从EEC皮肤获取的样本染色在统计学上无显著差异（p>0.05）。与接受或未接受胆脂瘤的COM手术患者的EEC皮肤相比，原发性和继发性获得性胆脂瘤上皮中bcl-2表达降低，bax和c-erbB-2表达增加，且差异具有统计学意义（p<0.05）。
与EEC皮肤相比，在获得性胆脂瘤上皮中，bcl-2表达降低以及bax和c-erbB-2表达增加的结果表明细胞增殖和细胞凋亡均增加。
