S-100蛋白和NSE在先天性巨结肠诊断中的协同作用

Synergic effect of S-100 and NSE in the diagnosis of Hirschsprung's disease

目的:探讨S-100蛋白和神经细胞特异性烯醇化酶(NSE)在先天性巨结肠(HD)中的表达及其意义。方法:结合光镜下肠壁神经节细胞的形态特征,并应用免疫组化技术对25例临床及病理诊断为先天性巨结肠的病变肠段行S-100和NSE染色,比较染色结果和分布特点。结果:扩张段及狭窄段结肠壁中S-100在神经丛内的神经纤维、雪旺细胞及周围细胞均有阳性表达,NSE呈弱阳性表达;而在神经节细胞中NSE呈阳性表达,S-100则呈阴性表达。扩张段及狭窄段中神经节细胞数差异有显著性,神经纤维数差异无显著性(P>0.05),但是前者神经纤维直径明显较后者大(P<0.01)。结论:S-100,NSE可协同互补作为HD明确诊断的重要标记物,为临床HD的正确诊断、治疗提供依据。

Objective：To explore and discuss the expression and significance of S-100 and NSE protein in the colon of the patients with Hirschsprung＇s disease. Methods ： Combined with the morphological character of the gaogliocyte in the intestinal wall under microscope, the stained result and distributed character of the diseased intestinal segment in clinical and pathological diagnosed as congenital macrocolon was stained and compared with S-100 and NSE and with the immunohistochemistrical technique. Results： The nerve fibers, Schwann＇s cell and the peripheral cell in the nervous plexuses of the colonic wall of the distended and strictured segments were positive to S-100 and weak positive to hSE, but NSE was positive expression in the gangliocyte and negative to S-100. There was significant difference in the number of the gangliocyte between the distended and strictured segments, but there was no significant difference in the density of nerve fiber （P〈0.05）. The diameter of nerve fiber in the distended segment was larger than that in the strictured one （P 〈0.01）. Conclusion： Mutual synergic complement of S-100 protein and NSE can regard as an important marker for unambiguous diagnosis of HD, and provides gist for the diagnosis and treatment of HD in clinic.