Distribution,expression And Significance Of Mast Cells, Substance P And Melanocytes In Intraepithelial Non Tumor Like Lesion Of The Vulva

Objective: To explore the relationship between the distribution and expression of mast cells,substance P and melanocytes in the intraepithelial non tumor like lesion of the vulva and the occurrence of the lesions.Method: We retained 75 cases of gynecological surgical resection or biopsy paraffin specimens from the First China Medical University between the year of 2012 and 2016,including 20 cases of vulvar squamous cell hyperplasia and 40 cases of vulvar lichen sclerosus(including 20 cases of early stage and 20 cases of advanced stage)and 15 cases of normal vulvar skin.Immunohistochemical S-P method was used to detect the distribution and expressions of mast cell tryptase,substance P and HMB-45.Meta Morph(UIC/OLUMPUS.US/JP)was used to measure the integral light density of the positive expression of the specimen.Each slice was randomly selected 5 high power fields in the lesion area from the epidermis basal layer,the superficial layer of dermis and the deep layer of dermis.Calculate the mean integral optical density of the same slice,which represented the staining intensity of the number of positive cells.The collected data were processed by SPSS 22.0 software.The average optical density was expressed by`X±s,and t test was performed.P<0.05 represented the difference had statistically significant.Result: 1.The degree of infiltration of mast cells in normal vulvar dermis and vulvar squamous cell hyperplasia was the same,the difference was not statistically significant(p>0.05).Mast cells infiltrated more in the early VLS lesions of the superficial dermis than normal vulva skin,and the difference was statistically significant(P<0.05).The infiltration of mast cells in the superficial layer of the dermis was reduced and the increased in the deep layer during advanced stage,and the difference was statistically significant(P<0.05).2.Substance P had almost no expression in the normal dermis of the vulva and the advanced stage of VLS,but expressed high in the vulvar squamous cell hyperplasia and the early stage of VLS,and the difference was statistically significant(P<0.05).3.The infiltration of melanocytes was increased in the vulvar squamous cell hyperplasia compare with the normal vulva skin,and the difference was statistically significant(P<0.05).There was no significant difference(p>0.05)of the melanocytesbtween the early vulvar lichen sclerosing(VLS)and the normal vulvar skin.In the advanced stage of VLS,the number of melanocytes was significantly(P<0.05)lower than that of the normal skin.Conclusion: 1.The pruritus of vulvar squamous cell hyperplasia is associated with the increase of substance P.The pruritus of early vulvar lichen sclerosus is associated with the growth of substance P and mast cell.2.The loss of skin pigmentation during the advanced stage is associated with the reduction of melanocyte.