The Distributions Of Enteric Nervou, Smooth Muscle, Interstitial Cells Of Cajal In Human Meckel's Diverticulum And Their Clinical Significance

Objective:Through investigating the alterations of enteric nervous,smooth muscles and interstitial cells of Cajal(ICCs)in the resected intestines from patients with Meckel's diverticulum(MD),this study was to discuss the pathogenesy of Meckel's diverticulum and its complications,and to explore the range of resected intestinal segments in primary operation.Methods:Full thickness intestinal samples were obtained from 44 patients undergoing surgery for Meckel's diverticulum.Six controls were obtained from infants or young children who had died without gastrointestinal or neuroal system diseases.All specimens were stained with haematoxylin and eosin(HE)to count the number of myenteric plexus and the number of ganglion cells under light microscope.In addition,all specimens were processed for SABC immunohistochrnistry by using different monoclonal antibody to NSE,S-100 protein,a-smooth muscle actin(a-SMA)and c-kit protein.Results:Patients with MD had normal numbers of myenteric plexus neurones compared with controls(P＞0.05).We found the reduction of ganglionic cell and average area and average long axis of myenteric nerve plexus in MD,but the average optical is increased in MD.Average area of myenteric nerve plexus in MD was closely correlated with it average optical(r=-0.215, P＜0.05).A remarkably reduced staining intensity for a-SMA was mainly observed in highly hypertrophic circular muscle layer of MD.A few ICCs were observed around the myenteric plexus in MD.The alteration patterns of neuroal elements and ICCs were markedly sligh in the segment beyond 5cm from diverticulum,but its circular muscle was still hypertrohy.Conclusion:Hypoplasia of intramural nerves and ICCs was seen in Meckel's dirverticulum. Hypertrophy and reduced immunoreactivity for a-SMA were observed predominantly in the circular muscle layer of Meckel's dirverticulum.These alterations may contribute to the the pathogenesy of Meckel's dirverticulum and its complications.Most of these alterations became slight,when the intestinal range was beyond 5cm from dirverticulum.