The Expressions And Significance Of Sex Hormone Receptor In Pathologic Scars

Background and Object: The pathologic scars are the common diseases in plastic surgery. They are the results of anomalous recovery of raw surface after skin destruction, and they include hyperplastic scar (HS) and keloid (K). The scars affect beautiful outlook, and result in stress, and even affected organic function. The synulotic mechanisms are extraordinary complicated, and the influential factors are various. There is no satisfied therapeutics in pathologic scars, especially in keloid.The endocrinium is the important regulation system of human body, and it has close linkage with the occurrence and evolution of scars. The skin is the target organ of sex hormone, and the sex hormone react via propotional sex hormone receptor. The clinical data indicate that the synulotic course diversify with various sexuality, age, especially in critique age and gestation period. It demonstrates that there are correlations between synulotic course and sex hormone. This study is to investigate the characteristics of expression and distribution of estrogen receptor (ER) , progesterone receptor (PR) and androgen receptor (AR) in the hypertrophic scar, keloid and normal skin, and explore the effect of sex hormone receptor in the occurrence and evolution of keloid and hyperplastic scar. So that to provide a potential theoretic in anti-sex hormone therapy of the pathologic scars.Methods The expressive quantity and site of ER, PR and AR were detected by using immunohistochemical staining and light microscopy in 20cases of hypertrophic scar of maturity period, 20 cases of hypertrophic scar of multiplication period, 20cases of keloid, and 10 cases of normal skin. The samples collected in the surgery were fomalin fixation and paraffin imbedding as routine method. Sections of five urn paraffin block derived from each case were stained for ER^ PR and AR using SP immunohistochemical technique. Using HE staining, pathology changes were observed and were used to assess the expression of ER, PR and AR at scars and normal matched skin. Those cell nucleuses whose colors were stained to be brown-yellow were identified to be positive cells. Cell counting was performed at high power(400X), we counted 100 nuclei from 3separate areas for each section. ERx PR and AR positive grade was scored as follows -(<10%), +(10%~ 29%), ++(30%~49%), +++(>50%). The immunohistochemincal staining kit for ER, PR and AR were purchased from Beijing Zhongshan Biotechnilogical company. The experiment was performed according to the instructional manual of the kit. Tissue section of breast cancer and prostate cancer were provided by Beijing Hingham Biotechnological company and used as positive control for ER> PR and AR. PBS, instead of the first antibody, was used as a negative control. All data were analyzed with the statistical software of SPSS 11.5 for windows.Result (l)The expressive site of ER, PR and AR was in the nucleus of basal keratinocytes, dermal fibroblasts, coil gland and vascular endothelium of NS, HS and K tissues.(2) The positive rate of the expression of ER>PR and AR in normal skin was 30%, 20%, 20% respectively; and in HS of maturity period was 50%, 35%, 55% respectively; and in HS of multiplication period was 45%, 55%, 65% respectively; and in keloid was 70%, 35%, 75% respectively.(3) The expressive quantity of ER in keloid tissues was higher than NS tissues and HS of maturity period, and the expressive quantity of AR in HS of multiplication period and keloid was higher than NS tissues (P<0.05), and there was no significant difference between the HS of maturity period and Ktissues in the expressive quantity of ERv PR and AR (P>0.05);' There was no significant difference among keloid, HS and NS tissues in the expressive quantity of PR. There was no significant positive-correlation between them (P>0.05).(4) There were no correlations of the expressive level between ER and PR, AR and ER, or PR and AR.Conclusion (1) The positive rate of the expression of ERnPR and AR in normal skin, HS of maturity period, HS of multiplication period and keloid is different.(2) ER play a role in the formation and development of keloid.(3)AR play a role in formation and development of HS of multiplication period and keloid.(4) The role of PR in pathologic scars is not important.(5)The difference of positive rate of ER> PR and AR between HS of multiplication period and keloid has no statistically significant.(6)The positive expressive level of ER^ PR and AR in pathologic scars has no statistically significant.