Pathological changes of interstitial cells of Cajal and ganglion cells in the segment of resected bowel in Hirschsprung's disease
Pathological changes of interstitial cells of Cajal and ganglion cells in the segment of resected bowel in Hirschsprung's disease
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先天性巨结肠切除肠段Cajal间质细胞和神经节细胞的病理变化
DOI：
10.1007/s00383-016-3961-7
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发表时间：
2016-11-01
影响因子：
1.8
通讯作者：
Feng, Jiexiong
中科院分区：
文献类型：
--
作者：
Chen, Xuyong;Zhang, Hongyi;Feng, Jiexiong
本研究旨在探讨先天性巨结肠（HD）患者切除肠段中Cajal间质细胞（ICC）和神经节细胞的病理变化，以及探索使用造影剂灌肠（CE）和24小时延迟X线造影的益处。我们对58例HD患儿进行了回顾性分析，这些患儿接受了拖出手术。每次手术后，使用免疫组织化学染色方法分析钡残留物（A层）和切除的近端肠段（B层）近端末端中存在的ICC和神经节细胞。术后随访1年，记录患者排便频率、排便控制能力及术后可能发生的并发症，免疫组化染色显示A层ICC少于B层（p < 0.05）。但两个层面的神经节细胞密度差异无显著性（p > 0.05）。吻合口狭窄1例，小肠结肠炎5例，钡剂潴留肠段ICC密度明显降低。CE可能是预测HD患者肠切除长度的有价值的工具。
This study was conducted to investigate the pathological changes which occur in interstitial cells of Cajal (ICCs) and ganglion cells found in segments of resected bowel obtained from patients with Hirschsprung's disease (HD), as well as to explore the benefits of using a contrast enema (CE) with 24-h delayed X-ray films to predict the length of resected bowel.We performed a retrospective analysis of 58 children with HD who had undergone the pull-through procedure. After each operation, the ICCs and ganglion cells present in the proximal ends of the barium residue (Level A) and resected proximal bowel segment (Level B) were analyzed using immunohistochemical staining methods. Each patient was followed up for 1 year to record their stool frequency, defecation control ability, and post-surgical complications which may have occurred.Immunohistochemical staining detected fewer ICCs in Level A than in Level B (p < 0.05). However, the density of ganglion cells in the two levels was not significantly different (p > 0.05). One patient had anastomotic stricture, and five patients suffered from enterocolitis.The density of ICCs was significantly lower in the bowel segments that displayed barium retention. A CE may be a valuable tool for predicting the length of bowel resection in patients with HD.