Pathological Study Of Pediatric Neuronal Intestinal Malformations

Objectives:Clinical and pathological data was contrasted and studied retrospectively.By the way of discussing on clinical and pathological characteristics of Hirschsprung's disease and Hirschsprung allied disease, evaluating the role of synaptophysin in HD and HAD.The purpose is to know HD and HAD deeply,to increase accurate rate of preoperative and postoperative pathologic diagnosis.Methods:We collected the dates of 60 Hirschsprung's disease(HD) cases hospitalized from October 2006 to October 2008,gathered the tissue paraffin block of narrow zone,expansion zone.Ten cases of control group are the patients without Hirschsprung's disease.Immunohistochemistrical labeling were performed in 70 cases for SY to diagnosis IGCs and nervous plexus Combining together HE stain we divide the experimental group into two groups:HD group and doubtful HAD group.Summarizing clinical information,HE and immunohistochemistrical labeling,to summarize the clinical and pathological features of HD and HAD.Then combined with the clinical prognosis of follow-up results of the experimental data,compare the incidence rates of enterocolitis after operation between the HD group and doubtful HAD group.Results:1.All patients had a history of constipation and abdominal distension.A Comparison of the cases of enterocolitis after operation showed that there is great difference in the HD group and doubtful HAD group(P<0.05). 2.In the control group,the immunoreactivities of SY were widely distributed in the circular muscle layer.In the dilated colon with HD and HAD,the immunoreactivities of SY were positive or moderately positive.In the aganglionic segment,the immunoreactivities of SY were absent.The narrow zones' expression of SY in control group is more intense than experimental group(P <0.05).The expansion zones' expression of SY in control group isn't more intense than experimental group(P>0.05).3.The pathology of the cases of Hirschsprung allied disease suggested 8 cases of neuronal intestinal dysplasia,8 cases of hypoganglionosis,3 casea of immaturity of ganglion cells, 1 cases of neuronal hypogenesis.Conclusion:1.The circular muscle layer from the constricted segment is confirmed to be a region with poor innervation including extrinsic nerve,resulting in muscle spasm and stiffness.2.Synaptophysin immunoactivities only expressed in colon ganglion cells and nerve fiber,it dosen't expressed in Schwann cells and perineural statelite cells,and the result is easy to know.To combine together the HE dyeing,synaptophysin immunoactivities can easy to observe the morphous and developmental condition of colon ganglion cells,providing a methed of the pathologic diagnosis of neuronal intestinal dysplasia.3.synaptophysin immunoactivities can raise the rate of final diagnosis,can be taken as a method of auxiliary diagnosis.These are beneficial to the laying of operation and the evaluation of prognostic.