1型和2型黏蛋白在新生儿坏死性小肠结肠炎患儿肠组织中的表达变化

Expression of mucin-1 and mucin-2 in intestinal tissue of neonatal necrotizing enterocolitis

目的观察新生儿坏死性小肠结肠炎(NEC)患儿肠黏膜屏障中1型和2型黏蛋白(MUC1和MUC2)的表达变化。方法病例对照研究。NEC组为重庆医科大学附属儿童医院病理科NEC患儿手术肠组织病理切片中随机选取10份,并查阅住院病历收集一般临床资料;对照组为重庆医科大学附属儿童医院病理科先天性肠闭锁病理切片,以选取的NEC患儿的胎龄、发病日龄行1∶1匹配,利用HE染色对NEC组肠组织结构变化进行研究,以免疫组织化学方法对肠组织样本中MUC1及MUC2的表达变化进行分析。结果 NEC组及对照组肠组织在结构上有明显差异,NEC组患儿肠组织结构的完整性破坏甚至消失,表现为大量绒毛脱落、坏死,黏膜下层及肌层水肿,毛细血管扩张充血,样本肠壁层炎性细胞浸润,肠组织杯状细胞及隐窝减少; NEC患儿肠组织MUC1及MUC2表达均明显低于对照组(以累计光密度值统计,MUC1中位数:NEC组780 455.5 vs对照组19 175 070.4,P=0.004; MUC2中位数:NEC组3 039 120 vs对照组45 750 707.5,P=0.001)。结论 NEC患儿肠黏膜屏障中MUC1及MUC2表达显著降低,可能参与了NEC的发病过程。

Objective To observe the expression of mucin-1(MUC1)and mucin-2(MUC2)in intestinal tissue of neonatal necrotizing enterocolitis(NEC).Methods This is a case-control study.Ten intestinal tissue samples of neonates with NEC at Children's Hospital of Chongqing Medical University were selected randomly as NEC group and their general clinical data were collected.Neonates with congenital intestinal atresia were matched 1∶1 with NEC group mainly based on gestational age and day of disease onset.All the samples were tested by HE-staining and immunohistochemistry methods.Results The structure of intestinal tissue with NEC was significantly different from that in the control group.The former was mainly demonstrated as rupture of the integrity of intestinal tissue.Expression levels of MUC1 and MUC2 in intestinal tissue of neonatal NEC were both significantly decreased compared with the controls(statistically analyzed by integrated optical density,IOD).The median of MUC1 IOD was 780 455.5 in NEC group,and 19 175 070.4 in the control group,P=0.004.The median of MUC2 IOD was 3 039 120 in NEC group,and 45 750 707.5 in the control group,P=0.001.Conclusion MUC1 and MUC2 were key elements of intestinal mucosal barrier and may take part in the pathogenesis of NEC.