Cajal间质细胞在先天性巨结肠不同肠段的分布  

Distribution of Interstitial Cells of Cajal in Different Segments of Hirschsprung′s Disease

作　　者：侯豫[1] 杨烨[1] 赵新[1] 仝海霞[1] 王宝西[1] 

机构地区：[1]第四军医大学唐都医院儿科,西安710038

出　　处：《实用儿科临床杂志》2009年第7期508-510,共3页Journal of Applied Clinical Pediatrics

基　　金：陕西省自然科学基金项目资助(2003C2022)

摘　　要：目的检测先天性巨结肠(HD)患儿结肠手术标本组织Cajal间质细胞(ICC)的分布及形态,分析并统计其在不同肠段的分布数量,为研究HD的发病机制和功能障碍提供必要的实验依据。方法收集42例经病理诊断为HD的标本。男33例,女9例;年龄2个月～10岁。实验标本均为散发病例,全部取材经组织病理学检测符合HD诊断。应用免疫组织化学技术检测42例HD患儿手术标本狭窄段(狭窄段组)、移行段(移行段组)和扩张段(扩张段组)组织ICC的分布及数量,及5例肠套叠患儿(对照组,男4例,女1例;年龄30 d～8岁)结肠手术标本组织ICC的分布及数量。结果1.对照组结肠组织ICC主要分布于黏膜下丛(IC-SM)和肌间丛(IC-MY),在环肌层和纵肌层(IC-IM)也有分布。IC-SM、IC-MY在切面上呈连续性分布,相互连接形成网络状结构。2.结肠狭窄段组结肠组织ICC的分布显著减少或消失,较对照组和扩张段组均有显著性差异(Pa<0.001),IC-MY的网络状结构完全破坏,残存ICC形态异常;另狭窄段组2例ICC形态、分布及数量与对照组或扩张段组比较均无显著性差异;移行段组结肠组织内ICC的分布较对照组和扩张段组均显著减少(Pa<0.05),较狭窄段组显著增加(P<0.001),其形态部分接近正常,但IC-MY缺乏连续性分布,未能形成正常的网络状结构;扩张段组与对照组结肠组织内ICC分布相当,无显著性差异(P>0.05)。结论HD患儿结肠的不同肠段ICC的数量、形态、分布不同。在狭窄段IC-MY偶见残存的ICC,其形态变钝、突起减少或消失。ICC分布减少、形态异常可能是HD胃肠动力障碍的原因之一。Objective To investigate the distribution of interstitial cells of Cajal （ICC） in different segments of Hirschsprung＇s disease （liD）. Methods Forty - two pairs of full thickness specimens （ aganglionic segments and ganglionic segments） from HD children were collectired from several hospitals soon after operation（ 33 male ,9 female, aged from 2 months to 10 years old）. All the specimens were sporadic cases,and all cases were proved by histopathologic diagnosis, another 5 colon specimens were obtained from intussusception patients as control group（4 male, 1 female, aged from 30 days to 8 years old）. The ICC distribution in different parts of HD segments and non - HD segments were detected by using immunohistochemistry. Results 1. ICC were mainly distributed in submucosal plexus （ IC - SM ） and myenteric plexus （ IC - MY） of the distal colon,and also distributed in circular muscle layer and longitudinal muscle layer （ IC - IM）. IC - MY were distributed continuously between the circular and longitudinal muscle layers and formed a network. 2. In the segments of HD, compared with control group and the ganglionic segments group, ICC were decreased obviously in 40 samples of aganglionic segments group （Pa 〈 0. 001 ）. The IC - MY network were disappeared, and the configuration of the residual ICC were abnormal. In the other 2 samples of aganglionic segments, the morphous, distribution and the the number ICC were no difference with control or ganglionic segments group. In the transitional zone group, ICC were reduced than those of ganglionic segments group and control group （ P 〈 0.05 ）, but were more than those of the aganglionic segments group （ P 〈 0. 001 ）. Their configuration were closed to normal, but the IC - MY did not form a normal network. There were no difference of the distribution of ICC in ganglionic segments group and control group （P 〉 0.05 ）. Conclusions The number, morphous and the distribution of ICC are different in each segments of HD. In most a

关 键 词：CAJAL间质细胞 巨结肠 先天性 免疫组织化学 

分 类 号：R726.5[医药卫生—儿科]