摘要
目的 探讨与分析胶质细胞源性神经生长因子(GDNF)、生长相关蛋白-43(GAP-43)、神经元特异性烯醇化酶(NSE)、S-100蛋白在先天性巨结肠(HD)患儿中的表达水平及意义.方法 选择2019年9月至2022年10月诊治的先天性巨结肠患儿72例作为巨结肠组,选择同期因其他非肠神经节病变而行结肠手术的患儿72例作为参照组.取两组的结肠全层病理标本并进行GDNF、GAP-43、NSE及S-100蛋白表达免疫组化分析,同时进行先天性巨结肠相关性小肠结肠炎(HAEC)诊断评分与相关性分析,取巨结肠组的不同肠段组织标本进行检测.结果 巨结肠组的结肠全层GDNF、GAP-43、NSE、S-100蛋白表达阳性率分别为77.8％、73.6％、81.9％、83.3％,显著高于参照组的22.2％、26.4％、20.8％、22.2％(P<0.001).先天性巨结肠患儿不同结肠区域(狭窄段、移行段、扩张段、正常段)的GDNF、GAP-43、NSE、S-100蛋白表达阳性率对比差异有统计学意义(P<0.001).巨结肠组的HAEC诊断评分与参照组相比明显提高(P<0.001).在巨结肠组中,Spearman分析显示HAEC诊断评分与结肠全层GDNF、GAP-43、NSE、S-100蛋白表达阳性率呈正相关(P<0.001).结论 先天性巨结肠患儿多伴有GDNF、GAP-43、NSE、S-100蛋白的高表达,与患儿病情存在相关性,值得临床关注.
Abstract
Objective To explore and analyze the expression levels and significance of glial cell derived neurotrophic fac-tor ( GDNF),growth-associated protein-43 ( GAP-43),neuron-specific enolase ( NSE),and S-100 protein in children with Hirschsprung's disease (HD).Methods 72 children with HD who were diagnosed and treated from September 2019 to Oc-tober 2022 were selected as HD group,and 72 children who underwent colon surgery for other non intestinal ganglion lesions during the same period were selected as control group.Colon full-thickness pathological specimens of the two groups were taken,and immunohistochemical analysis of GDNF,GAP-43,NSE,and S-100 protein expressions was performed.At the same time,diagnostic scoring and correlation analysis for Hirschsprungs-associated enterocolitis ( HAEC) were conducted,and tissue samples from different intestinal segments of the HD group were collected for testing.Results The positive ex-pression rates of GDNF,GAP-43,NSE,and S-100 proteins in the full-thickness colonic specimens of the HD group were 77.8％,73.6％,81.9％,and 83.3％,respectively,which were significantly higher than those in the control group (22.2％,26.4％,20.8％,and 22.2％,respectively) (P<0.001).There were statistically significant differences in the positive expression rates of GDNF,GAP-43,NSE,and S-100 proteins in different colonic regions ( narrow segment,transi-tional segment,dilated segment,and normal segment) of children with HD ( P<0.001).The HAEC diagnostic score of the HD group was significantly improved compared to that of the control group ( P<0.001).In the HD group,Spearman analysis showed that there was a positive correlation between the HAEC diagnostic score and the positive expression rates of GDNF,GAP-43,NSE,and S-100 proteins in the full-thickness of the colon (P<0.001).Conclusion Children with HD are most-ly accompanied by high expressions of GDNF,GAP-43,NSE and S-100 protein,which is related with the condition of chil-dren and deserves clinical attention.
维普
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