新生儿先天性巨结肠活检标本中Calretinin的诊断作用

发布时间：2018-08-11 11:11

【摘要】：目的探讨Calretinin在新生儿先天性巨结肠(hirschsprung disease,HD)活检标本中诊断的作用,为HD的早期准确诊断提供有益的帮助。方法收集疑似HD患儿首次行肠黏膜活检标本51例,分别行常规HE及免疫组化EnVision法染色,判读黏膜下层有无神经节细胞,并对Calretinin的染色特点、分布情况进行观察。结果 51例活检标本中,镜下见神经节细胞,同时Calretinin染色阳性者8例,排除HD诊断。HE染色未见神经节细胞,同时Calretinin染色阴性者39例,后经手术证实均为HD。剩余4例,其中2例HE染色未见神经节细胞,但Calretinin染色阳性,亦排除HD的诊断;另2例因黏膜下层组织稀少,未见Calretinin染色阳性的神经节细胞,但黏膜固有层内可见Calretinin染色阳性的神经纤维,再次活检证实有神经节细胞。结论新生儿及小婴儿由于神经节细胞发育不成熟,HE染色不易观察。因此,免疫组化标记Calretinin的表达对新生儿HD诊断具有重要的辅助作用。
[Abstract]:Objective to investigate the role of Calretinin in the diagnosis of neonatal hirschsprung disease HD biopsy specimens, and to provide useful help for the early accurate diagnosis of HD. Methods 51 specimens of suspected HD were collected for the first time. Routine HE and immunohistochemical EnVision staining were used to determine whether there were ganglion cells in the submucosa. The characteristics and distribution of Calretinin staining were observed. Results in 51 biopsy specimens, ganglion cells were found in 8 cases and Calretinin staining was positive in 8 cases. No ganglion cells were found in HD. He staining and Calretinin staining was negative in 39 cases. All of them were confirmed by operation. In the remaining 4 cases, no ganglion cells were found by HE staining, but the diagnosis of HD was excluded by Calretinin staining, the other 2 cases were not found Calretinin staining positive ganglion cells due to the scarcity of submucous tissue. However, Calretinin positive nerve fibers were found in lamina propria mucosa, and ganglion cells were confirmed by re-biopsy. Conclusion Neonates and small infants are difficult to observe by HE staining due to immature ganglion cells. Therefore, the expression of immunohistochemical marker Calretinin plays an important role in the diagnosis of neonatal HD.
【作者单位】：天津市儿童医院病理科;天津市儿童医院新生儿外科;
【分类号】：R722.1

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