先天性巨结肠病变肠段CAD、S-100的检测及意义

Detection and significance of CAD and S-100 protein in colonic wall of the sick segments with Hirschsprung′s disease

目的探讨检测先天性巨结肠(HD)病变肠段组织中组织蛋白酶D(CAD)、S-100的临床意义。方法31例经常规病理检查确诊的HD患儿,均行手术治疗,术后随访,并对其病变肠段组织中的CAD、S-100进行检测。取5例正常结肠组织(C组)作对照。结果 31例患儿手术后21例有肠炎、便秘(A组),10例无症状(B组)。CAD、S-100检测显示,A组肠管扩张段切缘神经节细胞缺如3例、减少5例、未成熟2例、发育不良1例,B组肠管扩张段切缘及C组肠管组织中神经节细胞未见异常。结论对HD病变肠段进行CAD、S-100检测,有助于HD的确诊,对HD病变切除范围的确定有指导作用,有利于减少术后肠炎、便秘等。

Objective To investigate the clinical significance of cathepsin D （CAD） and S-100 protein detection in the colonic wall of the sick segments in Hirsehsprung＇s disease（HD）. Methods CAD and S-100 was detected by immu- nohistochemistry in the colonic wail of the sick segments of 5 health person （group C） and 31 cases with HD were diag- nosed through the pathology and followed-up after operation. Results The main symptoms of 21 cases were enteritis and constipation （group A） while 10 cases （group B） did not show these conditions. In group A, ganglion cells was not found in 3 cases, and ganglion cells was found decreased in 5 cases, immature in 2 cases, dysplasia in one case. No abnomal gangliocyte were found in the edge of the distended segments of group B and C. Conclusions The detection of CAD and S-100 can be regarded as a useful diagnostic tool. In addition, it has the instruction function of exairesis range and can re- duce the complication of enteritis and constipation.