TGF-β1在学龄前儿童先天性双侧腹股沟斜疝疝囊壁中的表达

Expression level of TGF-β1 in the hernia sac of preschool children with congenital bilateral inguinal hernia

目的了解转化生长因子β1(TGF-β1)在双侧小儿腹股沟斜疝疝囊壁的表达情况并探讨小儿腹股沟斜疝的发生机制。方法选取2014年4月至2015年10月黔西南州人民医院普外科收治并手术的30例学龄前患儿双侧腹股沟斜疝疝囊壁的标本,用HE染色及免疫组织化染色方法,观察光镜下左右疝囊壁形态学特点及免疫组化染色下TGF-β1在小儿腹股沟斜疝左右两侧疝囊壁的表达情况。结果光镜下左右两侧疝囊壁中可见成纤维细胞增生、胶原细胞沉积,但左侧较少。TGF-β1在疝囊壁中阳性表达情况:右侧组33.33%,左侧组为80.00%。HIS积分右侧组为2,左侧组为10,右侧的TGF-β1在疝囊壁组织多呈低表达反应,强阳性表达少,而左侧呈现高表达反应,左右两侧差异有统计学意义(P<0.05)。结论 TGF-β1在儿童先天性双侧腹股沟斜疝疝囊壁的表达,右侧强度明显强于左侧。TGF-β1可能通过调节胶原合成代谢影响两侧腹股沟区腹膜抗张力强度,影响鞘状突的闭合及疝环局部结缔组织张力,先天性儿童腹股沟斜疝鞘状突未闭且右侧高发可能与TGF-β1有关。

Objective By comparing （transforming growth factor betal, TGF-β1 ） expression level in bilateral inguinal hernia sac wall, to explore possible mechanisms of child inguinal hernia. Methods 30 cases of＂ preschool children with bilateral inguinal who were admitted to Qianxinan People＇s Hospital from April 2014 to October 2015 were enrolled in this study. The sac wall specimens from their bilateral inguinal hernia were used to observe histopathological features and TGF-β1 expression level by way of HE and immunohistochemistry staining respectvely. Results The proliferation of fibroblasts and collagen fibers were seen in the hernia sac at the left and right sides of the hernia sac under light microscope, but the eollagen fibers deposited on the left side was less than that in the right side. Strong positive expression of TGF-β1 in the wall of hernia sac ： on the right side was 33.33%, and on the left was 80%. HIS integral on the right side was ：2 and on the left was 10. The right group of TGF-β1 in the hernia sac wall tissue showed low expression of reaction, less strong positive expression, while left group showed highly expressed reaction. The difference has statistical significance （P 〈 O. 05）. Conclusion The weaker TGF-/31 expression in right congenital inguinal hernia sac wall suggests that TGF-β1 may influence anti-tensile strength of the bilateral inguinal by regulating collagen synthesis, which is important to closure of the sheath and connective tissue tension of hernia ring. It may be the reason why child has congenital oblique hernia, patent processus vaginalis and the high incidence is often found in the right side.