慢传输性便秘患者乙状结肠组织中Cajal间质细胞的分布

Study on distribution of interstitial cells of Cajal in the sigmoid colon of patients with slow transit constipation

目的 了解Cajal间质细胞 (ICC)在慢传输性便秘 (STC)患者乙状结肠组织中的分布。方法 应用c kit单克隆抗体间接免疫荧光检测技术 ,对 12例STC患者和 8例对照组患者的乙状结肠组织中的ICC分布进行测定 ,激光共聚焦显微镜扫描图像 ,图像处理软件进行分析。结果 ICC广泛分布于结肠肌层中 ,包括纵肌层、肌间丛、环肌层和黏膜下环肌表面 ,形态主要表现为双极细胞和多突起细胞两种类型 ;肌间丛和环肌层ICC数量多于黏膜下环肌表面和纵肌层。与对照组相比 ,STC患者各个区域ICC均明显减少 (P <0 0 1)。部分病例黏膜下环肌表面ICC几乎消失。结论 STC患者结肠存在ICC减少 。

Objective Slow transit constipation (STC) is a colonic motor disorder whose etiology remains unclear Recent studies have demonstrated a crucial role for interstitial cells of Cajal (ICC) in regulation of intestinal motility The aim of this study was to examine the distribution of ICC within the normal sigmoid colon and STC patients Methods Twelve patients with STC and eight age matched controls were studied ICC were identified with a monoclonal antibody to c kit by an indirect immunofluorescence method Immunostained tissues were examined with a laser scanning confocal microscope and the area occupied by ICC was calculated with image analysis software Results ICC were located in the external muscle layers including longitudinal muscle (LM),myenteric plexus (MP),circular muscle (CM) and submucosal border (SMB) Two types of Kit positive ICC were observed: bipolar cells characterized by one or two long processes,and multipolar cells with long stellate processes extending in various directions A higher percentage of ICC was present in the MP regions and CM layers compared with the SMB and LM layers Tissues from STC patients showed considerably decreased in number of ICC located in the four regions (ICC LM,ICC MP,ICC CM,ICC SMP),especially for ICC SMP,almost completely disappeared Conclusion Decreased c kit+ ICC in number may play an important role in the pathophysiology of STC It remains to be determined whether loss of ICC is primary or secondary to another lesion