直肠内脱垂致梗阻性排便综合征患者直肠Cajal细胞的表达

The expression of the interstitial cells of Cajal in the rectum of patients with obstructed defecation syndrome.

目的探讨直肠内脱垂致梗阻性排便综合征(ODS)患者直肠Cajal间质细胞(ICC)数量的变化。方法选择行经肛吻合器直肠切除术(STARR)治疗的ODS患者13例(ODS组),取直肠全层标本进行常规HE染色及免疫组化染色,观察直肠ICC数量的变化。对照组为同期因重度脱垂性痔病行STARR的患者11例。结果常规光镜下观察,HE染色结果显示ODS组直肠黏膜层呈轻度慢性炎症改变,肌间神经丛和肌层未见明显异常。免疫组化结果显示,直肠ICC主要包括4个部分,即黏膜下的ICC(ICC-SMB)、环肌层ICC(ICC-CM)、肌间神经的ICC(ICC-MP)和纵肌层ICC(ICC-LM)。与对照组相比,ODS组直肠ICC-SMB、ICC-CM、ICC-MP和ICCLM数量均显著减少(P<0.05)。结论 ODS患者直肠ICC-SMB、ICC-CM、ICC-MP和ICC-LM数量均明显减少,其可能是ODS发病机制中的重要因素。

Objective To study the expression of the interstitial cells of Cajal（ ICC） in the rectum of patients with obstructive defecation syndrome（ ODS）. Methods The rectum specimens of 13 patients with ODS undergone stapled transanal rectal resection（ STARR） in our hospital since 2012 were collected. Full- thickness rectal specimens were stained with HE method and ICCs were evaluated by c- kit immunohistochemical staining. Eleven patients with severe prolapsed hemorrhoids undergone STARR in our hospital during the same period were enrolled as controls. Results HE staining showed the mucosa layer with mild chronic inflammatory in ODS patients,and there was no obvious abnormality in muscular layers or myenteric plexus. Immunohistochemistry showed that ICC was observed in all the four parts,namely submuscular ICC（ ICC- SMB）,circular muscular ICC（ ICC- CM）,myenteric plexus（ ICC- MP） and longitudinal muscular ICC（ ICC- LM）. However,compared with the control group,ICC in ODS patients were significantly reduced（ P〈0. 05）. Conclusion The counts of ICC- SMB,ICC- CM,ICC- MP and ICC- LM in the rectum of patients with ODS are significantly reduced.