肥大细胞、TLR3、TLR4在先天性肠无神经节细胞症中的分布与表达
发布时间：2018-11-27 15:29
【摘要】：目的 研究肥大细胞（Mast cell, MC）、神经纤维（nerve fiber）、Toll样受体3（Toll-like receptor3, TLR3）及Toll样受体4（Toll-like receptor4, TLR4）在先天性肠无神经节细胞症（Hirschsprung’s disease, HD）患者不同肠段中分布和表达情况，探究其分布和表达差异的临床意义。 方法 选择我院病理诊断为HD的手术切除结肠标本40例，另取尸检结直肠标本10例（心血管疾病死亡9例和狂犬病死亡1例）作为对照组。将40例实验组标本的痉挛段、移行段、扩张段及10例对照组肠段标本，采用HE染色、甲苯胺蓝化学染色、S-P免疫组织化学染色法及复合染色法进行处理，观察肥大细胞、神经纤维、TLR3、TLR4的分布表达及形态学变化情况，采用彩色病理图像分析软件进行半定量分析，运用SPSS17.0进行统计学处理。 结果 ①镜下肥大细胞呈圆形、梭形或不规则形，胞浆呈蓝紫色，胞核浅蓝色或不染色，主要集中在肠段黏膜层及黏膜下层，与血管或神经纤维毗邻，HD患者痉挛段肥大细胞较对照组及扩张段明显增多（P㩳0.05），脱颗粒现象明显。 ②S-100免疫反应阳性的神经纤维呈黄棕色颗粒，位于黏膜下神经丛及肌间神经丛中，呈散在的点状、线状或簇集分布。在HD患者痉挛段黏膜下层可见S-100阳性反应的神经纤维增生明显，染色增强，呈波浪形，，面积较对照组明显增大（P0.05）。肥大细胞密度与神经纤维的密度（r=0.573，P0.01）及面积（r=0.514，P0.01）存在正相关性。 ③TLR3定位于细胞胞质中，主要表达在粘膜层的上皮细胞、神经丛内的神经节细胞及神经纤维，对平均光密度分析比较，各个肠段中粘膜层中的TLR3表达无显著统计学差异（P0.05），肌间神经丛内TLR3表达存在统计学差异（P 0.05），从正常组到病变段递减。 ④TLR4主要在肠道肌层高表达，而在神经丛不表达或弱表达，HD痉挛段肌层内TLR4表达量与对照组及扩张段比较，明显增高(P0.05)。 结论 肥大细胞与神经纤维关系密切，两者的变化及相互作用在HD的发病中可能具有重要意义，肥大细胞数量变化及脱颗粒现象在肠无神经节细胞症的诊断具有一定意义；TLR3、TLR4在HD不同肠段的表达分别具有差异性，两者在肠无神经节细胞症的发病中可能起着一定作用，TLR3可以作为病理诊断巨结肠的标记物之一。
[Abstract]:Objective to study the role of (Mast cell, MC), nerve fiber (nerve fiber), Toll like receptor 3 (Toll-like receptor3, TLR3) and Toll like receptor 4 (Toll-like receptor4, TLR4) in the diagnosis of (Hirschsprung's disease, in congenital intestinal apogoneurosis. To explore the clinical significance of the distribution and expression of HD in different intestinal segments. Methods Forty surgically resected colon specimens diagnosed as HD and 10 autopsy colorectal specimens (9 died of cardiovascular disease and 1 death of rabies) were selected as control group. HE staining, toluidine blue staining, S-P immunohistochemical staining and compound staining were used to observe mast cells in 40 cases of spastic segment, transitional segment, dilated segment and 10 cases of control group, which were treated by HE staining, toluidine blue staining, S-P immunohistochemical staining and compound staining. The distribution, expression and morphologic changes of nerve fibers and TLR3,TLR4 were analyzed by color pathological image analysis software and statistically analyzed by SPSS17.0. Results 1Mast cells were round, fusiform or irregular, cytoplasm was blue-purple, nucleus was light blue or unstained, mainly concentrated in intestinal mucosa and submucous layer, adjacent to blood vessels or nerve fibers. The mast cells in spastic segment of HD patients were more than those in control group and dilated segment (P0. 05). The 2S-100 immunoreactive nerve fibers were yellowish brown, located in the submucous plexus and intermuscular plexus, and distributed in scattered dots, lines or clusters. S-100 positive nerve fibers in the submucosa of the spastic segment of HD patients were obviously proliferated, stained and wave-shaped, and the area was significantly larger than that of the control group (P0.05). There was a positive correlation between the density of mast cells and the density of nerve fibers (r ~ (0.573) P _ (0.01) and the area (r ~ (0.5 14) P _ (0.01). 3TLR3 was localized in cytoplasm and mainly expressed in epithelial cells in mucosal layer, ganglion cells and nerve fibers in plexus. The mean optical density was analyzed and compared. There was no significant difference in the expression of TLR3 in the mucosal layer of each intestinal segment (P0.05), but the expression of TLR3 in the myenteric plexus was significantly different (P 0.05), which decreased from normal group to pathological segment. The expression of 4TLR4 was mainly high in the intestinal myometrium, but not or weakly expressed in the nerve plexus. The expression of TLR4 in the muscular layer of HD spastic segment was significantly higher than that in the control group and the dilated segment (P0.05). Conclusion Mast cells are closely related to nerve fibers. The changes and interactions between mast cells and nerve fibers may play an important role in the pathogenesis of HD. The expression of TLR3,TLR4 in different intestinal segments of HD may play a role in the pathogenesis of AGC. TLR3 can be used as a marker for pathological diagnosis of Hirschsprung's disease.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R726.5
本文编号：2361293
[Abstract]:Objective to study the role of (Mast cell, MC), nerve fiber (nerve fiber), Toll like receptor 3 (Toll-like receptor3, TLR3) and Toll like receptor 4 (Toll-like receptor4, TLR4) in the diagnosis of (Hirschsprung's disease, in congenital intestinal apogoneurosis. To explore the clinical significance of the distribution and expression of HD in different intestinal segments. Methods Forty surgically resected colon specimens diagnosed as HD and 10 autopsy colorectal specimens (9 died of cardiovascular disease and 1 death of rabies) were selected as control group. HE staining, toluidine blue staining, S-P immunohistochemical staining and compound staining were used to observe mast cells in 40 cases of spastic segment, transitional segment, dilated segment and 10 cases of control group, which were treated by HE staining, toluidine blue staining, S-P immunohistochemical staining and compound staining. The distribution, expression and morphologic changes of nerve fibers and TLR3,TLR4 were analyzed by color pathological image analysis software and statistically analyzed by SPSS17.0. Results 1Mast cells were round, fusiform or irregular, cytoplasm was blue-purple, nucleus was light blue or unstained, mainly concentrated in intestinal mucosa and submucous layer, adjacent to blood vessels or nerve fibers. The mast cells in spastic segment of HD patients were more than those in control group and dilated segment (P0. 05). The 2S-100 immunoreactive nerve fibers were yellowish brown, located in the submucous plexus and intermuscular plexus, and distributed in scattered dots, lines or clusters. S-100 positive nerve fibers in the submucosa of the spastic segment of HD patients were obviously proliferated, stained and wave-shaped, and the area was significantly larger than that of the control group (P0.05). There was a positive correlation between the density of mast cells and the density of nerve fibers (r ~ (0.573) P _ (0.01) and the area (r ~ (0.5 14) P _ (0.01). 3TLR3 was localized in cytoplasm and mainly expressed in epithelial cells in mucosal layer, ganglion cells and nerve fibers in plexus. The mean optical density was analyzed and compared. There was no significant difference in the expression of TLR3 in the mucosal layer of each intestinal segment (P0.05), but the expression of TLR3 in the myenteric plexus was significantly different (P 0.05), which decreased from normal group to pathological segment. The expression of 4TLR4 was mainly high in the intestinal myometrium, but not or weakly expressed in the nerve plexus. The expression of TLR4 in the muscular layer of HD spastic segment was significantly higher than that in the control group and the dilated segment (P0.05). Conclusion Mast cells are closely related to nerve fibers. The changes and interactions between mast cells and nerve fibers may play an important role in the pathogenesis of HD. The expression of TLR3,TLR4 in different intestinal segments of HD may play a role in the pathogenesis of AGC. TLR3 can be used as a marker for pathological diagnosis of Hirschsprung's disease.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R726.5
【参考文献】
相关期刊论文 前3条
1 杨希林;方秀才;刘晓红;;胃肠道肥大细胞与肠神经系统的相互作用[J];胃肠病学;2010年04期
2 呼格吉乐图;苏布达;王志;杜山;赵治国;李云章;许乐仁;;肥大细胞的组织化学与超微结构异质性[J];细胞生物学杂志;2007年06期
3 陈雷铃,胡廷泽,刘继红,孟海英,郎诗明,金先庆;先天性巨结肠症与人类巨细胞病毒感染[J];中华小儿外科杂志;2002年03期
本文编号：2361293
本文链接：https://www.wllwen.com/yixuelunwen/eklw/2361293.html
最近更新
教材专著
