Caja1间质细胞和CX43在肾盂输尿管连接部梗阻段的表达及意义

发布时间：2018-04-16 17:29

  本文选题：C-kit + CX43　； 参考：《郑州大学》2013年硕士论文

【摘要】：目的 通过观察Cajal间质细胞和CX43(缝隙连接蛋白43)在先天性肾盂输尿管连接部梗阻段的表达与分布情况,探讨二者在小儿先天性肾积水发病中的作用及意义。 方法 收集郑州大学一附院小儿外科行先天性肾积水患儿的肾盂输尿管连接部组织标本35例设为实验组,其中男21例,女14例,平均年龄4.5岁(35天-14岁),左侧18例,右侧17例。将因为肾脏肿瘤行肾切除患者的肾盂输尿管连接处组织20例(排除肾盂输尿管连接处狭窄,肿瘤患者组织学证实无侵犯)设为对照组,男11例,女9例,平均年龄3.3岁(3月-6岁),左侧8例,右侧12例。福尔马林液固定,石蜡包埋各标本组织,并进行组织切片,采用HE染色了解梗阻段输尿管结构变化,应用免疫组织化学方法检测C-kit阳性的Cajal间质细胞及CX43阳性细胞的表达情况,并比较其差异及分析二者的相关性。 结果 1.HE染色：实验组发现输尿管梗阻段组织肌层肥厚、纤维组织增生、黏膜慢性炎症,对照组未见纤维组织增生。 2.C-kit:对照组肾盂输尿管连接部肌间可见较多C-kit阳性表达的Cajal间质细胞,细胞体积较大,呈梭形或星形,可见棕色的颗粒状物质位于胞质内,细胞核大,而核周胞质较少。浆膜及粘膜层未见梭形或星形的C-kit阳性细胞。实验组肌间可见少量Cajal间质细胞,部分标本未见阳性表达。实验组12例阳性表达,23例阴性表达,对照组17例阳性表达,3例阴性表达,实验组Cajal细胞的表达与对照组相比差异明显(x2=13.133,P0.05)。 3.CX43：对照组中肾盂输尿管连接部的环形肌和纵形肌交界处可见CX43阳性表达的缝隙连接蛋白,呈黄褐色颗粒状,部分沿血管壁分布,黏膜下层亦可见阳性表达。而实验组肌层偶尔可见CX43的阳性表达,大部分标本未见有阳性表达。实验组11例阳性表达,24例阴性表达,对照组16例阳性表达,4例阴性表达,实验组CX43的表达与对照组相比差异明显(x2=12.014,P0.05)。 4.实验组C-kit和CX43的阳性表达之间存在正相关(r=0.386,P0.05)。 5.实验组Cajal间质细胞的表达随肾积水肾盂分离程度的增大呈下降趋势(r=-0.486,P0.05)。 结论 1.Cajal间质细胞和CX43在先天性肾积水中表达均减少,两者的减少可能参与小儿先天性肾积水的发病过程,且有协同作用。 2.随着肾积水程度加重,Cajal间质细胞表达减少,它可能在先天性肾积水的进展中有重要作用。
[Abstract]:PurposeBy observing the expression and distribution of Cajal interstitial cells and CX43 (gap junction protein 43) in the obstruction segment of congenital ureteropelvic junction, the role and significance of them in the pathogenesis of congenital hydronephrosis in children were investigated.Method35 specimens of ureteropelvic junction were collected from children with congenital hydronephrosis in Department of Pediatric surgery, first affiliated Hospital of Zhengzhou University. Among them, 21 cases were males and 14 cases were females, with an average age of 4.5 years from 35 days to 14 years old, left side in 18 cases and right side in 17 cases.Twenty cases of renal pelvis and ureteral junction (excluding stricture of renal pelvis and ureteral junction, histologically confirmed by tumor) were set up as control group (11 males and 9 females).The average age was 3.3 years (3 months 6 years old), left 8 cases, right 12 cases.The specimens were fixed in formalin solution, embedded in paraffin wax, and sections were made. The changes of ureter structure in obstruction segment were studied by HE staining, and the expression of C-kit positive interstitial cells and CX43 positive cells in interstitial cells of C-kit were detected by immunohistochemical method.The differences were compared and the correlation between them was analyzed.Result1.HE staining: hypertrophy of myometrium, hyperplasia of fibrous tissue and chronic inflammation of mucous membrane were found in experimental group, but no hypertrophy of fibrous tissue was found in control group.2. C-kiti: in the control group, there were more Cajal interstitial cells with positive C-kit expression in the muscle of the ureteropelvic junction. The cells were larger, fusiform or stellate, and brown granules were located in the cytoplasm with large nuclei and less pericyte.No fusiform or stellate C-kit positive cells were found in serous and mucosal layers.A small number of Cajal interstitial cells were found in the muscle of the experimental group, and no positive expression was found in some specimens.There were 12 cases with positive expression and 23 cases with negative expression in experimental group and 17 cases in control group. The expression of Cajal cells in experimental group was significantly different from that in control group (P 0.05).3. CX43: in the control group, the junction of ring muscle and longitudinal muscle of ureteropelvic junction showed CX43 positive expression of gap junction protein, which was yellowish brown granular, partly distributed along the vascular wall, and positive expression could also be seen in the submucosa.The positive expression of CX43 was occasionally found in the muscle layer of the experimental group, and no positive expression was found in most of the specimens.The expression of CX43 in the experimental group was significantly different from that in the control group (P 0.05) and that in the experimental group (n = 11) was significantly higher than that in the control group (n = 24). The positive expression of CX43 was negative in 24 cases in the experimental group and in 4 cases in the control group.4.There was a positive correlation between the positive expression of C-kit and CX43 in the experimental group.5.The expression of Cajal interstitial cells in the experimental group decreased with the increase of the separation degree of hydronephrosis.ConclusionThe expression of 1.Cajal interstitial cells and CX43 in congenital hydronephrosis was decreased. The decrease of 1.Cajal and CX43 may be involved in the pathogenesis of congenital hydronephrosis in children and have synergistic effect.2.With the exacerbation of hydronephrosis, the expression of interstitial cells of Cajal may play an important role in the progression of congenital hydronephrosis.
【学位授予单位】：郑州大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R726.9

【参考文献】

中国期刊全文数据库 前6条

1 李浩川,朱桂彬,李桂波,赵海军,李玉林;TGF_β·VEGF及PCNA在胚胎肠管的表达及其生物学意义[J];白求恩医科大学学报;1998年03期

2 史洪涛;陈东风;;Cajal间质细胞的功能与基础[J];重庆医学;2007年15期

3 王跃闵;谢桐;黄滨;;输尿管的蠕动生理和压力关系[J];国外医学.泌尿系统分册;1990年03期

4 高红,张志波,王维林,黄英;先天性巨结肠Pax3和Cx43基因突变及表达[J];世界华人消化杂志;2004年09期

5 曾维惠 ,谭升顺 ,姚聪君 ,张磐谏 ,王冬云;白癜风皮损中NPYVIP和SP的研究[J];中国皮肤性病学杂志;2002年01期

6 陈荣权,陈香美,崔世维,蔡广研,师锁柱,谢院生,吕杨,彭丽霞;组织金属蛋白酶抑制物在老年大鼠肾小管间质病理损害中的动态变化[J];中华老年医学杂志;2004年04期

，

本文编号：1759903