Keloids are a major complication related to surgical wound healing and very challenging condition to treat. Many treatment options are available, but the efficacy of the treatment is poor in most of cases and some keloids do not respond to the treatment at all. We compared the efficacy of intralesional 5-fluorouracil (5-FU) and triamcinolone (TAC) injections in a double-blind randomized controlled trial (RCT). Forty-three patients with 50 keloid scars were treated with either intralesional TAC or 5-FU-injections over 6 months. We wanted to find out whether biological features (cell density, cell proliferation rate, vascular density, myofibroblast numbers, steroid hormone receptor expression) in keloids could be used to predict the response to therapy and define the biological changes that take place in patients receiving a response. As there was no statistically significant difference in the remission rate between TAC and 5-FU treatments, all patients were combined and analyzed as responders and nonresponders. Although responders have slightly more myofibroblasts than the nonresponders in their keloids in the pretreatment biopsy samples, we could not identify a single predictive factor that could identify those patients that respond to drug injections. The good clinical response to therapy is associated with the simultaneous reduction of myofibroblasts in the keloid. This study demonstrates that myofibroblasts are reduced in number in those keloids that were responsive to therapy, and that both 5-FU and TAC injections are useful for keloid treatment.

译文

:瘢痕are是与手术伤口愈合和非常具有挑战性的疾病相关的主要并发症。有许多治疗方法可供选择,但大多数情况下治疗效果较差,某些瘢痕loid对治疗完全无反应。在一项双盲随机对照试验(RCT)中,我们比较了病灶内5-氟尿嘧啶(5-FU)和曲安西龙(TAC)注射的疗效。对43例瘢痕les有50例的患者在6个月内进行了病灶内TAC或5-FU注射治疗。我们想找出瘢痕loid中的生物学特征(细胞密度,细胞增殖率,血管密度,成肌纤维细胞数量,类固醇激素受体表达)是否可用于预测对治疗的反应并确定接受抗癌药物的患者的生物学变化。回复。由于TAC和5-FU治疗之间的缓解率在统计学上没有显着差异,因此将所有患者合并并分析为缓解者和无缓解者。尽管在预处理活检样本中反应者的瘢痕loid中成肌纤维母细胞的数量比未反应者略多,但我们无法确定一个单一的预测因素可以识别出那些对药物注射有反应的患者。对治疗的良好临床反应与瘢痕loid中成纤维细胞的同时减少有关。这项研究表明,对治疗有反应的瘢痕loid中成纤维细胞的数量减少,并且5-FU和TAC注射均可用于瘢痕loid治疗。

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