Expression And Significance Of CK17 And TNF-α In Cholesteatoma Of Middle Ear

Objective:By observing the expression of CK17 and TNF-αin the epithelium of middle ear cholesteatoma and the normal skin of external auditory canal,and testing the correlation between them,the relationship between them and the occurrence and development of middle ear cholesteatoma,as well as the influence on the destruction of bone was discussed.Methods:The expression of CK17 and TNF-αin 30 cases of cholesteatoma(from middle ear cholesteatoma epithelial tissue)and 15 cases of control group(from external auditory canal normal skin tissue)were detected by immunohistochemistry.The specimens of the cholesteatoma group were divided into mild bone destruction group(n=13)and severe bone destruction group(n=17)according to the degree of bone destruction.The expressions of CK17 and TNF-αin the two groups were observed.The data were statistically analyzed by SPSS26.0 software package,the correlation between the expression of CK17 and TNF-αin middle ear cholesteatoma was tested by Spearman correlation analysis,and the expression of CK17 and TNF-αin mild bone destruction group and severe bone destruction group was analyzed by rank sum test.Results:1.In the cholesteatoma group,CK17 was mainly expressed in the cytoplasm and a few in the nucleus(as shown in Figure 1).The positive expression of CK17 was mainly moderate and strong,with a positive rate of 76.7%.In the control group,CK17 was mostly negative(as shown in Figure 2),and the positive rate was only 33.3%.There was a significant difference between the two(χ~2=7.200,P<0.05).2.In cholesteatoma group,TNF-αwas mainly located in cytoplasm and nucleus,and was densely distributed in the whole layer of middle ear cholesteatoma epithelium.The positive expression rate in cholesteatoma group was 80.0%,while that in control group was 40.0%.There was significant difference between the two groups(P<0.05).3.In 23 cases of cholesteatoma with positive expression of CK17,21 cases were positive for TNF-α,while 4 cases were negative for TNF-αin 7 cases of cholesteatoma with negative expression of CK17.There was significant difference between the two groups.At the same time,the correlation coefficient rs=0.512,P=0.004 of CK17 and TNF-αexpression in middle ear cholesteatoma was obtained by Spearman correlation analysis,indicating that the expression of CK17 and TNF-αwas positively correlated in middle ear cholesteatoma.4.In 17cases of severe bone destruction,there were 8 cases of strong positive expression of CK17 and9 cases of strong positive expression of TNF-α,while only 1 case of CK17 and 1 case of TNF-αwas strongly positive in 13 cases of mild bone destruction group.The expression levels of CK17 and TNF-αin severe bone destruction group were significantly higher than those in mild bone destruction group.Conclusions:1.CK17 and TNF-αshowed an abnormally high expression trend in middle ear cholesteatoma epithelial tissue,and their positive expression rate was significantly higher than that of normal skin tissue of external auditory canal,suggesting that CK17 and TNF-αmay play a role in the pathogenesis of middle ear cholesteatoma.2.The expression of CK17 and TNF-αin middle ear cholesteatoma was positively correlated,and the secretion of CK17 and TNF-αin severe bone destruction group is significantly higher than that in mild bone destruction group,suggesting that CK17 may promote the secretion of TNF-αand promote bone destruction of middle ear cholesteatoma,which may be one of the important reasons for bone resorption of middle ear cholesteatoma.