Does Keloid Histology Influence Recurrence?
Does Keloid Histology Influence Recurrence?
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瘢痕疙瘩组织学影响复发吗？
DOI：
10.1097/dad.0000000000001880
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发表时间：
2021-09-01
期刊：
影响因子：
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通讯作者：
Zuriel D
中科院分区：
文献类型：
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作者：
Nangole FW;Ouyang K;Anzala O;Ogeng'o J;Agak GW;Zuriel D
瘢痕疙瘩是一种纤维增生性疾病，其特点是复发率高，已知影响其复发率的因素很少。我们进行了一项研究，以确定瘢痕疙瘩的组织学是否影响复发。这是一项前瞻性纵向研究，旨在确定瘢痕疙瘩的组织病理学参数是否影响复发。2018年8月至2020年7月，肯雅塔国家医院对手术切除的瘢痕疙瘩患者进行了随访。切除的瘢痕疙瘩用苏木精、/伊红、马松和三色染色进行组织学处理。用热点技术分析载玻片的炎症细胞、成纤维细胞和毛细血管密度，并与瘢痕疙瘩复发相关。术后随访至少1年。该研究共招募了90名患有104个瘢痕疙瘩的患者。瘢痕疙瘩复发率为28.6%。每HPF中淋巴细胞、成纤维细胞和巨噬细胞的绝对计数超过50与疾病复发之间存在相关性。对上述参数的敏感性和特异性分别为；淋巴细胞分别为48%和81%，巨噬细胞为57%和83%，肥大细胞为32%和33%，成纤维细胞为41%和91%。肥大细胞和血管状况与复发无相关性。因此，应进行常规组织学检查以确定这些参数。对于巨噬细胞和/或淋巴细胞升高的患者，应考虑密切监测和二线治疗，以降低复发风险。
Keloids are fibroproliferative disorders characterized by high recurrence rates, with few factors known to influence the same. We conducted a study to determine whether keloids histology influences recurrence. This was a prospective longitudinal study to determine whether histopathological parameters of keloid influence recurrence. Patients with keloids managed by surgical excision were followed up at Kenyatta National Hospital between August 2018 and July 2020. The excised keloids were processed for histology using Hematoxylin, /Eosin, Masson, and Trichrome stains. The slides were analyzed for inflammatory cells, fibroblasts and capillary density using the hot spot technique and correlated to keloid recurrence. Postoperative follow-up was for a minimum of one year. A total of 90 patients with 104 keloids were recuited in the study. Overall keloid recurrence rate was 28.6 percent. There was a correlation between the absolute count of more than 50 per HPF of lymphocytes, fibroblasts, and macrophages with recurrence of the disease. The sensitivity and specificity for the above parameters were ;lymphocytes 48 and 81 %, macrophages 57 and 83 %, Mast cells 32and 33 % and fibroblasts at 41 and 91% respectively. There was no correlation between mast cells and vascularity status with recurrence. Routine histology should, therefore, be performed to determine these parameters. Close monitoring and second-line therapy should be considered for patients with elevated macrophages and or lymphocytes so as to reduce the risk of recurrence.