Research Of CAD And S-100 Protein In Prognosis Of Hirschsprung's Disease

Objective To investigate the clinical significance of CAD and S-100 Protein in the wall of colon in Hir schsprung' s Disease.Methods 111 cases with common type HD were followed-up after trans-anal One~stage Soave pull through operation(74 cases were followed). 32 cases(male 20,female 12) were grouped which the youngest was forty-four days old and the maximum was seven years old. They were diagnosed by barium enema, anorectal manometry etc before surgery and Confirmed by pathological examination after surgery. The main symptoms of symptomatic group (group A,n=22) were diarrhea, abdominal distention,constipation, enteritis, fever, intestinal obstruction which often needed the treatment of coloclysis ,and anti-inflammatory, etc while asymptomatic group (group B,n=10) did not show these conditions, 5 cases were chosen as the normal control group(group C, n=5) from the operation of transverse colon or sigmoid colon stoma which had mature ganglion cell in the intestinal wall. Combined with the morphological character of the gangliocyte in the intestinal wall under microscope, the stained result and distributed character of the diseased intestinal segment was stained and compared with CAD and S-100 with the immunohistochemistrical technique.Results Most of the gangliocyte in the nervous plexuses of the colonic wall of the distended segments from group A were weak positive to CAD,few positive or negative,while from group A and C were all positive . The gangliocyte in the nervous plexuses and nerve fiber of strictured intestine was lack and negative to CAD. The blank area was rarely observed in the colonic wall of the distended segments of few cases from group A and the nerve fiber of strictured intestine was strong positive to S-100,whose conguration was hyperplasia and distorted,while, the blank area was observed normally in the colonic wall of the distended segments of few cases from group B and C. There was significant difference in the number of the gangliocyte between the distended segments of group A and B by CAD and S-100 with the immunohistochemistrical technique.Conclusions Mutual synergic complement of CAD protein and s-100 can regard as an important marker for unambiguous diagnosis of HD, and provides the basis for the limits of surgical resection for HD.