發(fā)布時間：2018-04-16 17:29

  本文選題：C-kit + CX43��； 參考：《鄭州大學》2013年碩士論文

【摘要】：目的 通過觀察Cajal間質(zhì)細胞和CX43(縫隙連接蛋白43)在先天性腎盂輸尿管連接部梗阻段的表達與分布情況,探討二者在小兒先天性腎積水發(fā)病中的作用及意義。 方法 收集鄭州大學一附院小兒外科行先天性腎積水患兒的腎盂輸尿管連接部組織標本35例設(shè)為實驗組,其中男21例,女14例,平均年齡4.5歲(35天-14歲),左側(cè)18例,右側(cè)17例。將因為腎臟腫瘤行腎切除患者的腎盂輸尿管連接處組織20例(排除腎盂輸尿管連接處狹窄,腫瘤患者組織學證實無侵犯)設(shè)為對照組,男11例,女9例,平均年齡3.3歲(3月-6歲),左側(cè)8例,右側(cè)12例。福爾馬林液固定,石蠟包埋各標本組織,并進行組織切片,采用HE染色了解梗阻段輸尿管結(jié)構(gòu)變化,應(yīng)用免疫組織化學方法檢測C-kit陽性的Cajal間質(zhì)細胞及CX43陽性細胞的表達情況,并比較其差異及分析二者的相關(guān)性。 結(jié)果 1.HE染色：實驗組發(fā)現(xiàn)輸尿管梗阻段組織肌層肥厚、纖維組織增生、黏膜慢性炎癥,對照組未見纖維組織增生。 2.C-kit:對照組腎盂輸尿管連接部肌間可見較多C-kit陽性表達的Cajal間質(zhì)細胞,細胞體積較大,呈梭形或星形,可見棕色的顆粒狀物質(zhì)位于胞質(zhì)內(nèi),細胞核大,而核周胞質(zhì)較少。漿膜及粘膜層未見梭形或星形的C-kit陽性細胞。實驗組肌間可見少量Cajal間質(zhì)細胞,部分標本未見陽性表達。實驗組12例陽性表達,23例陰性表達,對照組17例陽性表達,3例陰性表達,實驗組Cajal細胞的表達與對照組相比差異明顯(x2=13.133,P0.05)。 3.CX43：對照組中腎盂輸尿管連接部的環(huán)形肌和縱形肌交界處可見CX43陽性表達的縫隙連接蛋白,呈黃褐色顆粒狀,部分沿血管壁分布,黏膜下層亦可見陽性表達。而實驗組肌層偶爾可見CX43的陽性表達,大部分標本未見有陽性表達。實驗組11例陽性表達,24例陰性表達,對照組16例陽性表達,4例陰性表達,實驗組CX43的表達與對照組相比差異明顯(x2=12.014,P0.05)。 4.實驗組C-kit和CX43的陽性表達之間存在正相關(guān)(r=0.386,P0.05)。 5.實驗組Cajal間質(zhì)細胞的表達隨腎積水腎盂分離程度的增大呈下降趨勢(r=-0.486,P0.05)。 結(jié)論 1.Cajal間質(zhì)細胞和CX43在先天性腎積水中表達均減少,兩者的減少可能參與小兒先天性腎積水的發(fā)病過程,且有協(xié)同作用。 2.隨著腎積水程度加重,Cajal間質(zhì)細胞表達減少,它可能在先天性腎積水的進展中有重要作用。
[Abstract]:PurposeBy observing the expression and distribution of Cajal interstitial cells and CX43 (gap junction protein 43) in the obstruction segment of congenital ureteropelvic junction, the role and significance of them in the pathogenesis of congenital hydronephrosis in children were investigated.Method35 specimens of ureteropelvic junction were collected from children with congenital hydronephrosis in Department of Pediatric surgery, first affiliated Hospital of Zhengzhou University. Among them, 21 cases were males and 14 cases were females, with an average age of 4.5 years from 35 days to 14 years old, left side in 18 cases and right side in 17 cases.Twenty cases of renal pelvis and ureteral junction (excluding stricture of renal pelvis and ureteral junction, histologically confirmed by tumor) were set up as control group (11 males and 9 females).The average age was 3.3 years (3 months 6 years old), left 8 cases, right 12 cases.The specimens were fixed in formalin solution, embedded in paraffin wax, and sections were made. The changes of ureter structure in obstruction segment were studied by HE staining, and the expression of C-kit positive interstitial cells and CX43 positive cells in interstitial cells of C-kit were detected by immunohistochemical method.The differences were compared and the correlation between them was analyzed.Result1.HE staining: hypertrophy of myometrium, hyperplasia of fibrous tissue and chronic inflammation of mucous membrane were found in experimental group, but no hypertrophy of fibrous tissue was found in control group.2. C-kiti: in the control group, there were more Cajal interstitial cells with positive C-kit expression in the muscle of the ureteropelvic junction. The cells were larger, fusiform or stellate, and brown granules were located in the cytoplasm with large nuclei and less pericyte.No fusiform or stellate C-kit positive cells were found in serous and mucosal layers.A small number of Cajal interstitial cells were found in the muscle of the experimental group, and no positive expression was found in some specimens.There were 12 cases with positive expression and 23 cases with negative expression in experimental group and 17 cases in control group. The expression of Cajal cells in experimental group was significantly different from that in control group (P 0.05).3. CX43: in the control group, the junction of ring muscle and longitudinal muscle of ureteropelvic junction showed CX43 positive expression of gap junction protein, which was yellowish brown granular, partly distributed along the vascular wall, and positive expression could also be seen in the submucosa.The positive expression of CX43 was occasionally found in the muscle layer of the experimental group, and no positive expression was found in most of the specimens.The expression of CX43 in the experimental group was significantly different from that in the control group (P 0.05) and that in the experimental group (n = 11) was significantly higher than that in the control group (n = 24). The positive expression of CX43 was negative in 24 cases in the experimental group and in 4 cases in the control group.4.There was a positive correlation between the positive expression of C-kit and CX43 in the experimental group.5.The expression of Cajal interstitial cells in the experimental group decreased with the increase of the separation degree of hydronephrosis.ConclusionThe expression of 1.Cajal interstitial cells and CX43 in congenital hydronephrosis was decreased. The decrease of 1.Cajal and CX43 may be involved in the pathogenesis of congenital hydronephrosis in children and have synergistic effect.2.With the exacerbation of hydronephrosis, the expression of interstitial cells of Cajal may play an important role in the progression of congenital hydronephrosis.
【學位授予單位】：鄭州大學
【學位級別】：碩士
【學位授予年份】：2013
【分類號】：R726.9

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本文編號：1759903