Cajal间质细胞在出口梗阻性便秘直肠肌壁中的表达相关研究

Expression of Cajal mesenchymal cells in the rectal muscle wall of outlet obstructive constipation

目的研究Cajal间质细胞在出口梗阻性便秘(OOC)直肠肌壁中的表达情况并予以分析。方法将华中科技大学协和江北医院从2018年8月2日至2020年8月16日收治的OOC患者45例纳入研究,记作研究组。另取同期收治的混合痔患者45例作为对照组。分别以改良TST法切除术采集两组的梗阻段肠黏膜和肌壁,采用免疫组织化学法检测Cajal间质细胞的特异性标志物CD117表达情况。随后采用人工计数以及免疫组织化学分析软件明确CD117在两组直肠肠壁不同区域中的异常表达情况,组间比较采用χ^(2)或t检验。结果研究组CD117阳性细胞于直肠肠壁黏膜固有层的计数为(15.72±0.74)个,明显高于对照组的(7.89±0.70)个,而在黏膜下层以及固有肌层中的计数分别为(28.34±0.37)、(10.32±0.61)个,低于对照组的(41.06±0.45)、(15.30±0.70)个(t=35.980,P<0.05)。研究组CD117阳性细胞于直肠肠壁黏膜固有层中的积分吸光度(IOD)值为(32.25±0.52)个,高于对照组的(27.47±0.39)个,而黏膜下层以及固有肌层中的IOD值分别为(8.80±0.67)、(5.32±0.90)个,均低于对照组的(18.02±0.80)、(12.31±0.57)个(t=44.015,P<0.05)。正常Cajal间质细胞形态主要呈纺锤状或星状,而OOC组患者的细胞染色相对变弱,形态呈圆钝,形成神经网络变少,且在黏膜固有层中的CD117阳性表达的细胞几乎无改变,甚至出现增加,细胞形态无显著改变。结论 Cajal间质细胞在OOC直肠肌壁黏膜固有层中存在明显高表达,而在直肠肌壁黏膜下层以及固有肌层中存在异常低表达。

Objective To study the expression of Cajal stromal cells in the rectal muscle wall of patients with outlet obstructive constipation(OOC).Methods A total of 45 patients with OOC admitted to our hospital from August 2,2018 to August 16,2020 were included in this study and recorded as the study group.A total of 45 patients with mixed hemorrhoids treated in the same period served taken as the control group.Immunohistochemistry was used to detect the expression of specific marker CD117 in Cajal mesenchymal cells.Then manual counting and histochemical analysis software were used to observe the abnormal changes of CD117 expression in different regions of rectum and intestinal wall in the two groups.Results The number of CD117 positive cells in the lamina propria of rectal and intestinal wall in the study group was(15.72±0.74),which was significantly greater than that in the control group(7.89±0.70).The number of CD117 positive cells in the submucosa and muscular layer of strudy group was(28.34±0.37)and(10.32±0.61),respectively,which was significantly less than in the control group[(41.06±0.45)and(15.30±0.70),t=35.980,P<0.05].In the study group,the IOD value of CD117 positive cells in the mucosal lamina propria of rectal and intestinal wall was(32.25±0.52),which was significantly higher than that in the control group(27.47±0.39).In the submucosal and muscular layers,the IOD value in the study group was(8.80±0.67)and(5.32±0.90)respectively,which was significantly lower than that in the control group[(18.02±0.80)and(12.31±0.57),t=44.015,P<0.05].The normal interstitial cells of Cajal were mainly fusiform or stellate,while the cells in OOC group were relatively weak in staining,round and dull in morphology,and the formation of neural networks was reduced.The CD117 positive cells in the mucosal lamina propria almost did not change,or even increased,without significant changes in cell morphology.Conclusion The expression of Cajal interstitial cells is obviously high in the mucosal lamina propria of the rectal muscle wall of OOC,while the expression is abnormally low in the submucosal and muscular layer of the rectal muscle wall.