Study in Tissues Damage by Phenol and TCA Peels and clinical applications

1.针对三氯乙酸（TCA）或苯酚处理皮肤的伤口愈合，我们研究了角蛋白6、7、10和16的表达模式以及人β 1整合素和腱生素的免疫组织化学分布。结果表明，三氯乙酸处理的皮肤和苯酚处理的皮肤的表皮组织学变化在苏木精-伊红染色的石蜡切片中非常相似，但显示免疫组化染色不同。然而，在真皮苯酚渗透到皮肤迅速，并诱导内皮细胞的变化和苯酚果皮可能不同于TCA果皮的组织学效应。在苯酚损伤的组织中，通过TUNEL方法和活化的Caspase-3的表达阳性检测到皮肤变性。然而，我们没有观察到p53或Fas的上调。同时TCA剥离皮肤显示阳性反应的TUNEL法，但不通过Caspase-3激活，Fas，或p53。这些结果表明，苯酚剥脱后的皮肤退化将通过激活Caspase-3导致细胞凋亡，这与TCA剥脱后的皮肤退化不同.对拒绝手术或手术困难的老年皮肤肿瘤患者，采用三氯乙酸（TCA）和/或苯酚皮片治疗，并随访1 ~ 4年。结果我们认为，光化性角化病（AK）、Bowen病和组织学浅表型基底细胞癌（BCC）可望用TCA和/或苯酚皮完全治愈。部分患者（2例AK和2例Bowen病）对治疗耐药。这些患者的肿瘤细胞在治疗过程中显示出强烈的p-53表达。

1. In view of wound healing in trichloroacetic acid(TCA) or phenol treated skin, we studied the expression patterns of keratin 6, 7, 10 and 16 and the immunohistochemical distribution of human beta-1 integrin and tenascin. In our result, histological changes of epidermis in TCA treated skin and phenol treated skin were very similar in the hematoxyline-eosin stained paraffin sections, but shows that the immunohistochemical stainings were differed. However, in the dermis phenol penetrated into the skin quickly and induced changes in endothelial cells and the phenol peels might differ from histological effects of TCA peels. In tissues damaged with phenol, skin degenerations were positively detected by a TUNEL method and expression of activated Caspase-3. However, we did not observe up-regulation of p53 or Fas. Meanwhile TCA peeled skins showed positive reaction by a TUNEL method, but not by Caspase-3 activation, Fas, or p53. These findings suggest that skin degenerations after phenol peels will lead to apoptosis via Caspase-3 activation, which differs from skin degenerations after TCA peels.2. In aged patients with skin tumor who refused the operation or had the difficulty in the surgery, we used TCA and/or phenol peels as a treatment and followed the clinical and histological course of them for one to 4 years. In the result we thought complete cure with TCA and/or phenol peels were expected for actinic keratosis(AK), Bowen's disease and basal cell carcinoma(BCC) of histologically superficial type. Some patients (2 AK and 2 Bowen's disease) were resistant to the therapy. The tumor cells in these patients showed strongly expression of p-53 during the course of the treatment.