CAJ | 학술논문

目的研究感染对阑尾Cajal间质细胞(interstitial cells of Cajal,ICCs)表型的影响.方法收集2008年1月至6月间我科收治64例化脓性阑尾炎和24例阑尾炎穿孔伴腹膜炎为病例组,并以17例阑尾脓肿治愈后6个月再次手术及非炎症性阑尾切除15例患儿作为对照.取阑尾全层组织行HE染色及c-Kit+免疫组织化学染色(Envision二步法),对照分析阑尾ICCs的c-Kit+表达情况,并同时分析4组患儿C反应蛋白(CRP)和前降钙素(PCT)的改变.结论 c-Kit+ICCs在脓肿后组分布较均匀,ICCs间距小,构成网络状结构.脓肿后组与对照组差异无统计学意义(P＝0.687);化脓组、腹膜炎组均分别较对照组明显减少,网络状结构破坏,差异有统计学意义(P＜0.001),腹膜炎组ICCs较化脓组减少更明显,差异有统计学意义(P＜0.001).CRP在化脓组(28.7±8.4)mg/L、腹膜炎组(116.1±34.3) mg/L较脓肿后组(2.8±0.6)mg/L均有明显升高(P＜0.001),腹膜炎组较化脓组升高更明显(P＜0.001),脓肿后组与对照组(2.2±0.4)mg/L均在正常范围;PCT在化脓组(0.96±0.31) ng/ml、腹膜炎组(2.08±0.59ng/ml)较脓肿后组(0.32±0.09)ng/ml均有明显升高(P＜0.001),腹膜炎组较化脓组升高更明显(P＜0.001),脓肿后组与对照组(0.17±0.04)ng/ml均在正常范围.结论感染与阑尾ICCs表型改变有关,感染越重c-Kit+ICCs减少越明显.感染控制后ICCs表型可恢复,网络状结构重新建立.
목적 연구감염대란미Cajal간질세포(interstitial cells of Cajal,ICCs)표형적영향.방법 수집2008년1월지6월간아과수치64례화농성란미염화24례란미염천공반복막염위병례조,병이17례란미농종치유후6개월재차수술급비염증성란미절제15례환인작위대조.취란미전층조직행HE염색급c-Kit+면역조직화학염색(Envision이보법),대조분석란미ICCs적c-Kit+표체정황,병동시분석4조환인C반응단백(CRP)화전강개소(PCT)적개변.결론 c-Kit+ICCs재농종후조분포교균균,ICCs간거소,구성망락상결구.농종후조여대조조차이무통계학의의(P＝0.687);화농조、복막염조균분별교대조조명현감소,망락상결구파배,차이유통계학의의(P＜0.001),복막염조ICCs교화농조감소경명현,차이유통계학의의(P＜0.001).CRP재화농조(28.7±8.4)mg/L、복막염조(116.1±34.3) mg/L교농종후조(2.8±0.6)mg/L균유명현승고(P＜0.001),복막염조교화농조승고경명현(P＜0.001),농종후조여대조조(2.2±0.4)mg/L균재정상범위;PCT재화농조(0.96±0.31) ng/ml、복막염조(2.08±0.59ng/ml)교농종후조(0.32±0.09)ng/ml균유명현승고(P＜0.001),복막염조교화농조승고경명현(P＜0.001),농종후조여대조조(0.17±0.04)ng/ml균재정상범위.결론 감염여란미ICCs표형개변유관,감염월중c-Kit+ICCs감소월명현.감염공제후ICCs표형가회복,망락상결구중신건립.
Objective To investigate the phenotypic alterations of interstitial cells of Cajal(ICCs) in children with appendicitis.Methods Appendectomy specimens and the levels of CRP and PCT from 64 patients with suppurative appendicitis(suppurative group),24 patients of perforated appendicitis with peritonitis(peritonitis group) and 17 patients with appendiceal abscess accepted conservative treatment and then with elective interval appendectomy 6 months later(abscess group) were respectively compared with appendectomy specimens and CRP and PCT from 15 control patients with congenital malrotation of intestine(control group).We investigated the ICCs distribution in 120 appendices of these patients using immunohistochemistry and anti-c-kit antibodies.Results Compared to control group,c-Kit+ICCs were abundant and showed a network structure in the appendices of abscess group and there was no significant difference between them.The number of c-kit+ ICCs was remarkably reduced or even disappeared and the network structures was destroyed in the both suppurative group and peritonitis group,and were significant less than those of the controls,there was a significant difference between suppurative group and peritonitis group in the distribution of c-Kit+ICCs.The CRP and PCT were significantly elevated in suppurative group (28.7±8.4mg/L,0.96±0.31ng/ml)and peritonitis group (116.1±34.3mg/L,2.08±0.59ng/ml),but maintained in normal levels in abscess group(2.8±0.6mg/L,0.32±0.09ng/ml).Conclusions Infection might lead to temporary losses of the phenotype and the network structure of ICCs,but these alterations can be recovered with recession of infection.