| Objective:To investigate the pathological changes characteristics ofEnteric nerves System(ENS),smooth muscle and interstitial cells ofCajal(ICCs) in congenital intestinal atresia as the reference for of surgicalresection.Methods:Nineteen patients with IA were studied.Specimens weretaken f rom the resected intestinal segments proximal and distal to theatresia. Five contr ols were obtained from postmortem neonates withoutgastro-intestinal or nervous system diseases.All specimens wereimmunochemically stained with a monoclonal antibody to S-100protein asa neuroglia cell marker, to α-smooth muscle actin(α-SMA) as a smoothmuscle marker and to c-kit protein as a marker of ICCs.Results:S-100, α-SMA and c-kit positive expressions weresignificantly lower than that of the controls within8cm proximal.Theindexes closed to the controls at11cm proximal.At20cm proximal and5cmdistal to the atresia,the indexes had no significant differences between thecontrols. The pathohistological alterations of ENS,smooth muscle and ICCsof intestine in IA patients occur in the proximal and distal segments of the atresia. Extremly expansion of the proximal atresia intestine,thedevelopmental delay of atresia intestinal in fetal period, the developmentand maturation of ENS and ICCs needing to continue after the birth,thedysfunction of c-kit expresssion in the ICCs of the proximal atresiaintestine,are probably the causes of histological abnormalities in both endsof the atresia intestine.Conclusions: Combined with postoperative clinical manifestations.The reasonable intestinal resection should include11cm of proximal and5cm of distal. |
