Cajal间质细胞在美克尔憩室中的分布研究及临床意义  

The distributions of smooth muscles,interstitial cells of Cajal in human Meckel's diverticulum and their clinical significance.

作　　者：席红卫[1] 吴晓霞[1] 崔彦北[1] 王建峰[1] 

机构地区：[1]山西省儿童医院外科,太原030013

出　　处：《临床小儿外科杂志》2007年第6期8-10,13,共4页Journal of Clinical Pediatric Surgery

摘　　要：目的了解美克尔憩室肠壁Cajal间质细胞的病理组织学改变及其分布范围,探讨美克尔憩室及其并发症的发病机制与临床意义。方法收集44例美克尔憩室患儿的小肠标本,分别选取憩室部及其两端肠壁全层组织,常规固定,石蜡包埋,切片,采用免疫组织化学染包法(SABC法)检测肠壁S-100、NSE、a-SMA和C-kit。以6例相同年龄,死于与肠道和神经系统无关疾病的足月新生儿尸检小肠标本为对照组,观察美克尔憩室肠壁平滑肌和肠间质细胞的病理组织学改变及其分布范围。结果美克尔憩室患儿肠壁环肌层和纵肌层a-SMA表达减低,环肌层肥厚:肠壁肌间Cajal间质细胞数减少,细胞间无正常网络状结构形成。而距憩室5 cm处肠壁各项指标和Cajal间质细胞的改变均减轻,环肌层明显肥厚,a-SMA染色减轻。结论我们推测平滑肌细胞和肠间质细胞可能参与了美克尔憩室及其并发症的发生。Objective To investigate the distributions of smooth muscles and interstitial cells of Cajal （ICCs） in the resected intestines from patients with Meckel＇s diverticulum （MD）, and to discuss the pathogenesis of Meckel＇s diverticulum and its complications. Methods Fouty-four cases of MD were studied. Six controls were obtained from postmortem neonates without gastrointestinal or neuronal system diseases. All specimens were processed for SABC immunohistochmistry by using different monoclonal antibody to NSE, S-100 protein, a-smooth muscleactin （a-SMA） and c-kit protein. Results A remarkably reduced staining intensity for a -SMA was mainly observed in highly hypertrophic circular muscle layer of MD. A few ICCs were observed around the myenteric plexus in MD. The alteration patterns of neuronal elements and ICCs were markedly slight in the segment beyond 5cm from diverticulum, but its circular muscle was still hypertrohy. Conclusions Smooth muscles and ICCs may contribute to the the pathogenesis of Meckel＇s dirverticulum and its complications.

关 键 词：美克耳憩室 CAJAL间质细胞 分布 临床意义 病理组织学 并发症 

分 类 号：R726.5[医药卫生—儿科]