先天性肾积水连接部狭窄段中细胞增殖与神经分布的表达及意义

Significance of cell proliferation and nerve innervation in congenital hydronephrosis

目的通过检测肾盂输尿管连接部狭窄段的细胞增殖与神经分布情况，进一步探讨先天性肾积水的发病机制。方法应用免疫组化pv-9000方法检测增殖细胞核抗原（proliferating cellnuclear antigen，PCNA）、神经肽Y（neuropeptide Y，NPY）在17例肾盂输尿管连接部狭窄段（病例组）和15例正常输尿管组（正常组）的表达情况。结果PCNA在病例组中13例阳性表达，主要位于黏膜层及纤维结缔组织层；4例阴性表达，但存在肌层肥厚。正常组中2例PCNA阳性表达，13例无表达，差异有统计学意义（P〈0．05）。NPY在病例组表达减少或缺如，5例阳性表达但减少，12例无表达；正常组13例NPY表达明显，2例无表达，差异有统计学意义（P〈0．05）。结论先天性肾积水肾盂输尿管连接部狭窄段的细胞增殖和神经分布减少在先天性肾积水发病过程中起着重要作用。

Objective To investigate the mechanisms of congenital hydronephrosis through detecting the cell proliferation and nerve innervation within ureteropelvic junction stenosis （UPJS）. Methods Immunohistochemistry was applied to measure the expression of proliferating cell nuclear antigen （PCNA） and neuropeptide Y （NPY） in 17 cases of UPJS and 15 normal ureter tissues as controls. Results In UPJS group, the expression of PCNA was positive in 13 cases, mainly located in mucous layer and fibrous connective tissue, the rest 4 cases was negative accompanied by thickening of muscular layer. Out of 15 normal controls, only 2 cases expressed PCNA, while the rest were negative, the difference was of statistical significance （P〈0. 05）. The expression of NPY was reduced in 5 cases and absent in 12 cases of UPJS, while it was positive in 13 cases of normal controls （P〈0.05）. Conclusions Cell proliferation and reduced nerve distribution within UPJS may play a critical role in the pathogenesis of congenital hydronephrosis.