【摘要】 目的分析钙视网膜蛋白在小儿肠无神经节细胞症诊断中的应用意义。方法回顾性分析本院自2011年1月1日至2014年12月31日收治的确诊小儿肠无神经节细胞症、肠神经节细胞发育异常症患儿术前直肠黏膜活检标本中钙视网膜蛋白的表达情况和HE染色结果、根治术或造瘘术后病变段钙视网膜蛋白表达情况和病理检查HE染色结果。结果①肠无神经节细胞症中术前直肠黏膜活检检查钙视网膜蛋白的表达在所有病例中阴性表达11 1/114例,HE染色未见神经节细胞112/114例;根治手术后痉挛段肠壁中钙视网膜蛋白均呈阴性表达133/133例,HE染色未见神经节细胞133/133例,而在扩张段的肠壁中钙视网膜蛋白的表达均呈阳性表达133/133例,HE染色可见发育正常的神经节细胞133/133例;②肠神经节细胞发育异常症中术前直肠粘膜活检钙视网膜蛋白表达阴性4/4例,HE染色见到发育不良神经节细胞1/4例,其余3例均未见到神经节细胞;根治术或造瘘术后病变段钙视网膜蛋白表达阳性42/42例,HE染色见到神经节细胞发育异常或减少42/42例。结论钙视网膜蛋白染色可以作为肠无神经节细胞症的诊断依据之一,但仍然有假阳性及假阴性结果可能,特别是在术前直肠粘膜活检的应用中。更多还原

【Abstract】 Objetive To analyze retrospectively the clinical significance of calretinin(CR)in the diagnosis of Hirschsprung’s disease(HD).Methods The expression of calretinin was detected and hematoxylin& eosin(HE) staining performed for spastic and expanding segments of HD and Hirschsprungs disease allied disorder from January 1,2011 to December 31,2014.Results Among them,111/114 cases had no preoperative expression of calretinin in spastic segment of HD.And 112/114 cases had no ganglion cells.None of 133 cases had an expression of calretinin in spastic segment and there were no ganglion cells.All 133 expanding segments had a positive postoperative expression of calretinin.HE staining showed that all 133 cases had normal ganglion cells.Four cases had no preoperative expression of calretinin in spastic segment of Hirschsprungs disease allied disorder,HE staining showed 3 cases without ganglion cells and 1 case with dysplasic ganglion cells.All 42 cases had an expression of calretinin in involved segments.All 42 cases had dysplasic ganglion cells or fewer ganglion cells.Conclusions Calretinin may be used for aiding the diagnosis of HD.When calretinin staining is used for diagnosing HD preoperatively,we should watch out for false positive and false negative results,especially during rectal mucosal biopsy.更多还原