中文摘要：

目的探讨角蛋白5（CK5）在原发性皮肤淀粉样变（PCA）中表达的病理意义。方法通过CK5单抗检测CK5在39例PCA和10例对照组[扁平苔藓（LP）、皮肤红斑狼疮（LE）]真皮浅层的表达;通过CD3和CD68抗体分别检测T淋巴细胞和巨噬细胞在PCA和对照组真皮浅层的浸润情况;通过免疫荧光共定位方法分析PCA和对照组真皮浅层巨噬细胞吞噬CK5的情况。结果 39例PCA的真皮浅层均见不同程度的CK5阳性;对照组部分为阳性。8例PCA皮损中浸润的T淋巴细胞及巨噬细胞计数均少于对照组;5例PCA皮损中CK5抗体与CD68抗体免疫荧光共定位分析结果为阴性,2例LE均为阳性,2例LP均为阴性。结论 PCA的淀粉样蛋白可能来自界面损伤后的基底层角质形成细胞;淀粉样蛋白的沉积可能与局部的巨噬细胞数量减少或吞噬功能缺陷有关。

英文摘要：

Objective To analyze the pathological significance of CK5 expression in primary cutaneous amyloidosis（PCA）.Methods The expression of CK5 in superficial dermis of PCA group and the control group[lichen planus（LP）,lupus erythematosus（LE）]were detected by CK5 monoclonal antibody.The infiltration densities of CD3-positive T lymphocytes and GD68-positive macrophages in superficial dermis of PCA and control group were measured respectively by immunohistochemical staining using anti-CD3 antibodies and anti-CD68 antibodies.The skin lesions of PCA and control groups were analyzed by immunofluorescence to detect whether CK5 was phagocytosed by macrophages in superficial dermis.Results Totally,39 cases of PCA all were CK5-positive,Some control cases were positive.The number of CD3-positive T lymphocytes and CD68-positive macrophages in 8 cases of PCA group was lower than that of control group.The result of immunofluorescence colocalization of monoclonal anti-CK5 antibodies and anti-CD68 antibodies in 5 cases of PCA lesions was negative;that in 2 cases of LE lesions were both positive,and that in 2 cases of LP lesions were both negative.Conclusion Amyloid protein may be derived from the basal keratinocytes after interface damage.The amyloid protein deposits may be related to the number decrease or the functional defect of macrophages.