The Kinetic Analysis of gastric peristalsis in the stomach resection using the distribution of Interstitial cells of Cajal and Electrogastrography

我们一直在用胃电检查切除后的胃蠕动功能。Imai曾报道，在远端胃切除病例中，全胃切除后没有胃电信号，而胃电信号依赖于胃切除的程度，并估计胃中的起搏结节可能存在于胃上部。本研究的目的是探讨胃蠕动功能与Cajal间质细胞(ICC)分布的关系。我们不仅关注迷走神经的胃蠕动，还关注ICC作为电触发的功能。本研究的最终目的是探讨如何在远端和近端胃切除后保持良好的生活质量。方法：采用组织病理学和免疫组织化学方法检测正常胃粘膜包括切除的胃组织中的ICC，采用c-Kit免疫组织化学方法。周围神经系统以S-100免疫组织化学染色为对照，显示粘膜下层和肌层，如奥尔巴赫神经节。结果与讨论：1)S-100染色显示迷走神经主要退出肌层；2)肌层存在c-Kit阳性细胞。S-100型与c-Kit定位略有不同。C-Kit阳性细胞也见于粘膜下层，尤其是粘膜下层。3)本研究有几个问题。除胃电分析外，无法获得残胃信息，如ICC分布。最初我们设计了研究，我们认为全胃切除标本是有用的。但许多全胃切除的组织都是进展期的胃癌，由于肿瘤的侵袭，很难找到正常的胃壁。

We have been investigating the resected stomach peristalsis function using Electrogastrography. Imai previously reported that there was no EGG signal after total gastrectomy and EGG signal depended upon the extent of gastric resection in distal gastrectomy cases, and estimated that the pacemaker node in the stomach probably exist upper part of stomach.The aim of this study is to examine the relationship between the function of peristalsis and distribution of Interstitial cells of Cajal (ICC).And we focused the stomach peristalsis not only vagal nerve but also the function of ICC as an electoronic trigger. Finally the end point of this study is how maintain the good QOL (quality of life) after distal and proximal gastrectomy.Methods :We have examined the normal mucosa including resected stomach of gastric cancer by histopathological and immunohistological method, to detect ICC, using c-Kit immuno-histochemical method. Peripheral nerve system was stained by S-100 immuno-histochemical staining as a contrast, which showed submucosal layer and muscular layer such as Auerbach's neuro-ganglion. c-Kit positive cells are located in not only musucular layer but also submucosal layer.Results & Discussions :1) S-100 staining, which means peripheral nerve tissue or cartilage tissue, showed vagal nerve system mainly exited muscular layer.2) c-Kit positive cell existed in the muscular layer. There is slightly difference of location S-100 and c-Kit. c-Kit positive cells are detected also in submucosal layer especially including the just under mucosal layer.3) There are a couple of issues for this research. We cannot obtain residual stomach information such as ICC distribution except EGG analysis. At first we designed the research, we thought total gastrectomy sample was useful. But many cases of total gastrectomy tissue consisted of advanced gastric cancer, it is difficult to find normal gastric wall due to cancer invasion.