Wnt5a在肛门直肠畸形患儿末端直肠组织中的表达及意义

Expression of Wnt5a in the terminal rectum of children with anorectal malformation

目的通过检测Wnt5a在肛门直肠畸形(ARM)患者末端直肠壁的表达,探讨其与ARM之间的可能关系。方法应用免疫组化和Western blot方法检测20例ARM患儿、7例后天性肠瘘和6例非胃肠道疾病患儿(对照组)末端直肠壁Wnt5a的表达并对比分析。结果对照组Wnt5a表达于直肠壁内肌间神经丛、黏膜层及黏膜下层,ARM组的末端直肠壁内Wnt5a表达较对照组减少,尤其高位畸形组减少更为明显。Western blot蛋白印迹结果:ARM高位组、中位组和低位组Wnt5a蛋白表达均明显低于对照组和后天肠瘘组(P<0.01)。高位组和中位组Wnt5a蛋白表达明显低于低位组(P<0.01)。后天瘘组与对照组比较差异无统计学意义。结论 Wnt5a在ARM末端直肠的表达水平减低,可能与ARM的发生密切相关。

Objective To study the expression of Wnt5a protein in the terminal rectum of children with anorectal malformation（ARM） and the possible association between Wnt5a and ARM.Methods Specimens were obtained from 20 children with ARM,7 children with acquired rectovestibular fistula and 6 children with non-gastrointestinal tract disease（control group）.The expression of Wnt5a protein in the terminal rectum was determined by immunohistochemistry and Western blot.Results Wnt5a was mainly expressed in the rectum of the myenteric nerve plexus,mucosal layer and submucosa in the control group.Compared with the control group,Wnt5a expression in the terminal rectum decreased significantly in the ARM group,and decreased more significantly in children with high ARM.The results of Western blot showed the expression of Wnt5a protein in the high,intermediate and low ARM groups were significantly lower than that in the acquired rectovestibular fistula and the control groups（P〈0.01）.The expression of Wnt5a protein in the high and the intermediate ARM groups were also lower than that in the low ARM group（P〈0.01）.There was no significant difference in the Wnt5a protein expression between the acquired rectovestibular fistula and the control groups.Conclusions The expression of Wnt5a in the termina1 rectum decreases in children with ARM,suggesting Wnt5a may play an important role in the development of ARM.