| Background & ObjectiveCongenital hydronephrosis is a frequent malformation in pediatric surgery, caused by complicated and multiple factors. The cause of hydronephrosis includes ureteropelvic junction stenosis,aberration blood vessel compression,ureteropelvic junction valve,ureter superior position,ureter initiation twisting or folding etal.Hydronephrosis caused by ureteropelvic junction stenosis is the most reason. In recent years, one of thousand fetus have hydronephrosis induced by ureteropelvic junction stenosis in ultrasonic inspection of antepartum. Boy is more than girl,left side more than right side;both side is to be meet.In the past, Most of the hydronephrotic kidneys were markedly enlarged with dilatation of the collecting system,tubular ectasia, apoptosis, tubular atrophy, interstitial cell infiltration and fibrosis etal. In resent years,the research show the pathogenesy of congenital hydronephrosis is closely related to interstitial fibrosis,chronic inflammation and innervation.Proliferating cell nuclear antigen (PCNA) change to follow cell cycle,existencing in proliferating cell nuclear,failure in rest cell.So PCNA estimate the index of cell proliferating activity by immunohistochemistry. The research show the majority (85%-95%) of nerve fibres within the ureter contained neuropeptide Y-like immunoreactivity (NPY-LIR),recently, abnormal innervation and decreased expression of neurotransmission have been implicated in the pathogenisis of intrinsic urinary. We study the expression of PCNA and NPY in the ureteropelvic junction stenosis by immunohistochemistry and carry out correlation analysis ,approaching congenital hydronephrosis pathogenesy from cell proliferating and innervention.Methods1 materials We take ureteropelvic junction stenosis cases certified by operation. All cases are in hospital . 15 normal ureter taken from ureter extenting to 2cm stenosis are control cases. All specimen are fixed in formalin, paraffin imbedding, chipping.2 empirical method All cases are dealed by HE dyeing, we observe histology change. Immunohistochemistry(PV-9000) was used to detect proliferating cell nuclear antigen (PCNA) and neuropeptide Y (NPY) in 17 cases and 15 normal issues, recording the positive and negative number of PCNA, NPY in cases and control cases.3 All number were analyzed by SPSS 10.0 statistics software , using x~2 analysis, Spearman rank correlation was applied to analyze correlation, P<0.05 has statistical significanceResults1 HE dyeing confirm mucous membrane chronic inflammation,fibroplasia,muscular layer pachynsis in hydronephrosis ureter,no fibroplasia in normal ureter.2 PCNA: The expression of PCNA in 13 cases is positive in 17 cases, mainly located in mucous layer and fibrousconnective tissue, and negtive in 4 cases,but have musclar layer pachynsis.Meanwhile,2 positive express is in normal cases, no musclar layer pachynsis. P<0.05 by x~2 analysis has statistical significance.3 NPY: The expression of NPY in 5 cases is positive in 17cases , 12 cases is negtive .it is 13 positive in 15 normal issues ,2 cases is negtive. Neuropeptide Y-containing nerves are present within the muscle layers, presenting fine line on longitudinal section , more liking courser within smooth muscle fiber parallelly, partly neuropeptide Y-immunoreactive nerve fibers are identified to surround the blood vessels, neuropeptide Y-containing nerves present point line on transection. P<0.05 by x~2 analysis has statistical significance.4 Correlation test: PCNA and NPY ranking standard are carried out to count fractionation in cases,analying the correlation of PCNA and NPY. P<0.05 by Spearman rank correlation analysis has statistical significance.Conclusion1. Compared to control cases, the expression of PCNA is obvious in ureteropelvic junction stenosis, neuropeptide Y-containing nerves is absence and reduced, The expression of PCNA and NPY in cases offer negative correlation.2. Cell proliferating and reduced innervation in ureteropelvic junction stenosis play a principal role in congenital hydronephrosis morbidity course... |
PDF Full Text Request