Cajal间质细胞凋亡在先天性巨结肠症及其同源病发病中的作用

发布时间：2018-02-23 01:59

本文关键词： Hirschsprung病间质细胞细胞凋亡　出处：《临床小儿外科杂志》2016年01期 　论文类型：期刊论文

【摘要】：目的探讨Cajal间质细胞(interstitial cells of Cajal,ICCs)凋亡在先天性巨结肠症(Hirschsprung's disease,HD)及其同源病(Hirschsprung's allied disease,HAD)结肠肌层中的表达及作用。方法 2014年2月至2015年2月我们采取腹腔镜手术治疗15例HD和13例HAD,切取HD痉挛段、移行段及扩张段和HAD近端与远端全层肠壁作检验组。另选取10例正常儿结肠标本作对照组。应用免疫荧光双标记技术检测不同病变肠管肌层中ICCs分布密度以及caspase-3、bcl-2表达情况。应用透射电镜观察不同病变肠管肌层中ICCs超微结构改变。结果结肠肌层中ICCs分布密度(个/视野)在HD组痉挛段(5.8±1.1)、移行段(10.0±1.8)及扩张段(13.1±2.1)和HAD组近端(16.5±2.4)与远端肠段(8.6±1.6),除HAD组近端与对照组(17.8±1.5)相比差异无统计学意义(P0.05)外,其余各组两两比较均存在明显差异(P0.05);各组中caspase-3阳性ICCs表达率分别为(77.6±13.8)%、(53.6±10.2)%、(31.9±8.0)%、(23.6±6.8)%、(57.2±12.1)%,均明显高于对照组的(6.3±4.3)%(P0.05);同时各组中bcl-2阳性ICCs表达率分别为(18.3±9.3)%、(31.5±7.3)%、(42.3±7.9)%、(48.7±6.5)%、(38.5±6.7)%,与对照组的(60.3±5.4)%相比均明显降低(P0.05)。ICCs分布密度与caspase-3表达呈负相关(r=-0.915,P0.01)、与bcl-2表达呈正相关(r=0.754,P0.01)。电镜观察HD组、HAD组病变肠管均发现ICCs凋亡样改变。结论 HD、HAD病变结肠肌层ICCs分布密度及caspase-3、bcl-2表达异常,表明ICCs细胞凋亡可能在HD、HAD的发病中发挥重要作用。
[Abstract]:Objective to investigate the expression and role of interstitial cells of Cajal interstitial cells of ICCs in the myometrium of Hirschsprungus disease (HD) and its homologous disease, Hirschsprungus allied disease (HADD). Methods from February 2014 to February 2015, 15 patients with Hirschsprungus allied disease were treated with laparoscopic surgery. HD and 13 HADs were removed from HD spastic segment. The transitional and dilated segments and the proximal and distal intestinal walls of HAD were used as the test group. Ten normal children colon specimens were selected as the control group. The distribution density of ICCs and caspase-3 bcl-2 in the myometrium of different lesions were detected by immunofluorescence double labeling technique. The ultrastructural changes of ICCs in the myometrium of different lesions were observed by transmission electron microscope. Results the distribution density of ICCs in the myenteric layer of colon was 5.8 卤1.1 in HD group, 10.0 卤1.8 in transitional segment and 13.1 卤2.1 in dilated segment in HD group and 16.5 卤2.4 in HAD group. There was no significant difference between the proximal end of HAD group and the control group (17.8 卤1.5), except that there was no significant difference (P 0.05) between the proximal end of the HAD group and the control group (P 0.05). The positive ICCs expression rate of caspase-3 in each group was 77.6 卤13.80.The positive ICCs expression rate was 53.6 卤10.2 卤31.9 卤8.0 in the other groups, which was significantly higher than that in the control group (60.3 卤5.4%), and the expression rate of bcl-2 positive ICCs in each group was 18.3 卤9.3 卤7.3m, 42.3 卤7.98.78.7 卤6.55.70.The expression rate was significantly lower than that in the control group (60.3 卤5.4% vs 60.3 卤5.4%), and the expression rate of bcl-2 positive ICCs was significantly lower than that of the control group (60.3 卤5.4ng%), and the expression rate of bcl-2 positive ICCs was significantly lower than that of the control group (60.3 卤5.4% vs 60.3 卤5.4%, respectively), and the expression rate of bcl-2 positive ICCs was 42.3 卤7.98.78.68.5 卤6.70.The positive ICCs expression rate in each group was significantly lower than that in the control group (60.3 卤5.4%), and the expression rate of bcl-2 positive ICCs was significantly lower than that in the control group. The distribution density was negatively correlated with the expression of caspase-3, and was positively correlated with the expression of bcl-2. ICCs apoptosis-like changes were found in the intestinal duct of HD group. Conclusion the distribution density of ICCs and the expression of caspase-3 bcl-2 in colon myometrium of HD group were abnormal. These results suggest that ICCs cell apoptosis may play an important role in the pathogenesis of HD had.
【作者单位】：河北医科大学第二医院小儿外科;
【基金】：国家卫生和计划生育委员会公益性行业科研专项(编号:201402007)
【分类号】：R726.5

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