Expression And Significance Of Cajal And CX43in Congenital Ureteropelvic Junction Obstruction

ObjectiveBy observing the expression of interstitial cells of Cajal and CX43(gap junction protein43) in congenital ureteropelvic junction obstruction, to discuss their role in the incidence of children with congenital hydronephrosis.Method35specimen of the ureteropelvic junction tissue samples collected as test group from the children who suffered congenital hydronephrosis in Pediatric Surgery of First Affiliated Hospital of Zhengzhou University,including21males and14females, with an average age of4.5years (35days to14years),18cases of left,17cases right.20specimen of ureteropelvic junction because of kidney tumors of renal tissue selected as controls (excludingUPJO,histologically confirmed non-infringement)11males and9females, with an average age of3.3years (3months to6years old),8cases of left and12cases right. Formalin-fixed, paraffin-embedded specimens of tissue, and tissue sections, HE staining for investigating structural changes, Immunohistochemistry was used to detect the C-kit-positive Cajal interstitial cells and Cx43-positive cells expressed and compare the differences and analysis of correlation between them.Result1.HE staining:Muscle hypertrophy,fibrosis,chronic inflammation of the mucous membranes were observed in test group, but no fibrous tissue hyperplasia in the control group.2.C-kit:There is many C-kit-positive interstitial cells of Cajal in the control group. Cajal cells were found in UPJ myenteric, showing spindle-shaped or star-shaped and brown granular material in the cytoplasm, big nucleus, and less perinuclear. There is no Cajal cells during serosal and mucosal layers. Less Cajal cells could be found in test group during the myenteric.12cases of positive expression and23cases negative in test group,17cases of positive and3cases of negative expression in control group.The expression of Cajal cells is significant different compared with the control group (x2=13.133, P<0.05).3.CX43:It could be observed the CX43postive expression at the junction of circular muscle and longitudinal muscle in control group.CX43is showing brown granular,part of them along the vessel wall and submucosa layer. Less positive expression of CX43in the muscular layer of the test group, there was no positive expression in some specimens.In test group,11cases of positive expression and24cases of negative.In control group,16cases of positive expression and4cases of negative.The expression of Connexin43expression is significant different compared with the control group (x2=12.014, P<0.05).4.1t is positive correlation (r=0.386, P<0.05) between C-kit and Cx43in test group.5.The expression of Cajal cells shows a downward trend with the increase of degree of hydronephrosis (r=-0.486, P<0.05)Conclusion1.The expression of Cajal cells and CX43decrease in congenital hydronephrosis,which may be involved in the pathogenesis of congenital hydronephrosis and the role of both of them is synergy.2.With the aggravation of hydronephrosis, the expression of Cajal interstitial cells decreases, it plays an important role in the progress of congenital hydronephrosis.