慢传输性便秘乙状结肠Cajal间质细胞分布的免疫组化观察

目的：Cajal间质细胞（interstitial cells of Cajal，ICC）对结肠动力有重要的调控作用。研究旨在初步观察ICC在STC乙状结肠的分布情况。方法：用ckit免疫组织化学技术观察了12例慢传输性便秘（slow transit constipation，STC）患者和8例对照组患者乙状结肠ICC形态和分布情况，并进行半定量分析。结果：ICC广泛分布于结肠肌层中，包括纵肌层（LM）、肌间丛（MP）、环肌层（CM）和黏膜下环肌表面（SMB）。ICC在形态上主要表现为双极细胞和多突起细胞两种类型。ICC—MP和ICC—CM相对多于ICC—SMB和ICC—LM。与对照组相比，STC患者各个区域ICC均明显减少（P〈0．01）。部分病例ICC—SMB几乎消失。结论：STC结肠ICC数量显著减少，但ICC减少是原发性的还是继发于某种其他损害仍有待探讨。

Distribution of Interstitial Cells of Cajal in the Sigmoid Colon of Patients with Slow Transit Constipation

Objective:The aim of this study was to examine the distribution of ICC within the normal sigmoid colon and STC patients.Methods:Twelve patients with STC and eight age-matched controls were studied. ICC were identified with a monoclonal antibody to c-kit by immunohistochemistry method. The area occupied by ICC was calculated with image analysis software.Results:ICC were located in the external muscle layers including longitudinal muscle (LM), myenteric plexus (MP), circular muscle (CM) and submucosal border (SMB). Two types of Kit-positive ICC were observed: bipolar cells characterized by one or two long processes, and multipolar cells with long stellate processes extending in various directions. A higher percentage of ICC was present in the MP regions and CM layers compared with the SMB and LM layers. Tissues from STC patients showed considerably decreased in number of ICC located in the four regions (ICC-LM, ICC-MP, ICC-CM, ICC-SMP), especially for ICC-SMP, almost completely disappeared.Conclusion:Decreased c-kit+ ICC in number may play an important role in the pathophysiology of STC. It remains to be determined whether loss of ICC is primary or secondary to another lesion.