ZHENG Shan,Basnet Anupama,HUANG Yan lei,et al.Evaluation of neuronal markers and innervations distribution in TCA appendix.[J].Journal of Clinical Pediatric Surgery,2011,10(01):0.
新生儿全结肠巨结肠阑尾壁内神经元标记物和神经支配分布的评价
- Title:
- Evaluation of neuronal markers and innervations distribution in TCA appendix.
- Keywords:
- Megacolon; Appedix; Neurons/IM; Infant; NewbornLaparoscopes; Hirschsprung disease; Therapy
- 摘要:
- 目的对新生儿全结肠巨结肠（TCA）阑尾神经分布的免疫组化进行研究，比较TCA阑尾和正常新生儿阑尾肠神经分布的差异。方法收集本院新生儿TCA患儿阑尾10例，将常见型HD近端正常乙状结肠组织和因肠旋转不良行阑尾切除术的10例新生儿设为对照组。采用免疫组化染色技术对S100蛋白、外周蛋白和蛋白基因产物9.5（PGP9.5）的表达进行比较，通过LEICADM生物显微镜下测量单位面积肌层组织中神经标记物阳性表达面积百分比。数据分析应用SPSS14.0软件进行t检验。结果①TCA患儿阑尾病理结果显示黏膜下和肌层没有或仅见少量神经干，神经节细胞缺如，对照组均找到神经干和发育成熟神经节细胞，但肠旋转不良阑尾管壁内神经节细胞发育较小，神经束和神经纤维亦明显减少。 ②对照组PGP9.5、外周蛋白和S100免疫组化染色均呈强阳性，但肠旋转不良阑尾组织染色密度明显低于正常乙状结肠组织（P<0.01）。 ③TCA阑尾壁内免疫表达阳性细胞缺如，神经纤维表达微弱或无表达，密度明显少于肠旋转不良组（P<0.01）。结论新生儿肠旋转不良阑尾仅见少量正常或发育不成熟的神经节细胞，神经标志物表达密度较正常乙状结肠明显减少，提示新生儿期阑尾神经束和神经节细胞可能存在发育未成熟；PGP9.5、S100和外周蛋白在新生儿TCA患儿阑尾的表达明显减少，可以帮助诊断。
- Abstract:
- ObjectiveThe aim of this study was to observe the innervation and ganglion cell distribution in TCA appendix. Method We have collected appendix of 10 patients who had gone through diagnostic laparotomy in our hospital for TCA. The appendixes of 10 patients of neonatal malrotation were taken as sham group. Control bowel specimens of the sigmoid colon (normal proximal segment) of 10 patients with HD were obtained. Immunohistochemistry was carried out by the invision technique, using antibodies against the S100 protein, peripherin, and protein gene product. The difference in the nerve fiber density calculated by the ratio of the sum of the areas occupied by positively stained nerve fibers per unit area of the muscle using computer software. Result ① Section (FS) biopsy and H&E stain result showed no ganglion cells and few or no nerve trunks in the submucosal and myenteric plexus of TCA appendix. In both sham group and control group, welldeveloped ganglion cells and nerve trunks were seen. But the sham appendix of malrotation demonstrated smaller ganglion cells and thin nerve bundles. ② The sigmoid colon and the sham appendix of malrotation showed a markedly positive PGP, Peripherin and S100 immunoreactivity (IR). But the density of the nerve bundles and nerve fiber did show significant reduction in appendices of malrotation (P<0.01). ③ The density of PGP9.5, S100 protein, and Peripherin staining in TCA appendix were significantly less than sham group and controlgroup (P<0.01). Conclusions Although the innervation and ganglion cell distribution in the neonatal appendix of malrotation demonstrated few normal and immature. Evaluation of neuronal markers and innervationsdistribution in TCA appendix also can accelerate diagnosis.
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备注/Memo
作者单位：复旦大学附属儿科医院外科（上海市，201102），Email:szheng@shmu.edu.cn，本研究为卫生部临床重点学科项目《新生儿重症畸形的诊断和治疗研究》（卫规财函\[2007\]353号）；国家科技支撑计划课题（编号：2006BA105A00）