小儿神经节细胞减少症肠壁肌间神经丛形态定量研究

The morphometric study of myenteric plexus of colon in children with hypoganglionosis

目的研究神经节细胞减少症的形态定量特征。方法对15例小儿节细胞减少症、14例无神经节细胞症及14例正常神经分布的肠壁组织进行常规石蜡切片,并作HE染色、NSE及S-100免疫组织化学染色,在光学显微镜图像分析系统下对三组标本的肠壁肌间神经丛组织进行形态定量测定并对各组测量参数进行统计学的分析比较。结果节细胞减少症肠肌神经丛中每毫米肠壁的平均神经节细胞数是1.52个(仅为正常组的24.3%),其每毫米肠壁的平均神经丛面积是(5.61×103)μm2(为正常组的17.3%),无神经节细胞症神经丛面积亦有明显减少,数量更少,NSE、S-100免疫组织化学染色可帮助正确辨别神经节细胞。结论肠壁肌间神经丛中神经节细胞数量减少的同时伴有神经丛面积的减小是节细胞减少症的特征性改变,肠肌神经丛的形态定量测定可作为神经节细胞减少症的客观诊断依据,彻底切除节细胞减少的肠段对于根治此症具有重要意义。

Objective To investigate the morphometric characteristics of hypoganglionosis. Methods The myenteric plexus of colon in paraffin sections from children with hypoganglionosis （n = 15）, aganglionosis （n = 14） and normal bowel （n = 14） were studied. The NSE and S-100 were immuno-stained. Results In hypoganglionosis group, the number of ganglia in myenteric plexus per mm colon was 1.52 （24. 3% of the normal colon）. The ganglion cross-section area per mm colon was 5.61× 10^3μm^2（17. 28% of the nonnal）. We also found that both the number and area of myenteric ganglia in aganglionosis were decreased significantly. Conclusions Hypoganglionosis of the myenteric plexus is characterized by significant decrease in the number of nerve cell and plexus area. The morphometric measurements of myenteric plexus are more reliable for the diagnosis of hypoganglionosis.