NSE和S-100在先天性巨结肠及其同源病诊断中的应用
Application of NSE and 5-100 in diagnosing Hirschsprung's disease and its allied disorders
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摘要: 目的：探讨神经元和神经胶质细胞标志物神经元特异性烯醇化酶(neuron-specificenolase，NSE)与S-100(soluble-protein100，S-100)在先天性巨结肠(Hirschsprungsdisease，HD)及其同源病(Hirschsprungsdiseaseallieddisorders，HAD)诊断中的作用。方法：对45例临床诊断为HD的手术切除标本进行常规HE染色，观察肠神经元及神经节细胞形态和数量的变化，并选择成人结肠肿瘤标本切缘正常组织作对照组进行比较。对HE染色光镜下可疑HD(即HAD)的21例标本进行NSE、S-100蛋白免疫组化测定。结果：对照组结肠壁神经丛中可见染色深浅不一的NSE免疫反应性神经节细胞，神经纤维均匀分布在肠壁各层；神经节细胞胞体对S-100蛋白则表现为细胞状空白区。HAD组结肠壁分化异常，狭窄段结肠壁神经丛内NSE神经节细胞中NSE呈明显阳性反应，S-100染色可见数量较少的细胞状空白区。结论：HD的诊断主要根据病理特征而定，在HE染色基础上结合NSE及S-100蛋白免疫组织化学染色能提高确诊率，为HD和HAD鉴别诊断提供依据。Abstract: To explore the values of neuronpecific enolase(NSE)and soluble-protein 100(S00)of the markers ofneuron and neuroglial in the diagnosis of Hirschsprung's disease(HD)and Hirschsprung's disease allied disorders(HAD). Methods:The morphological and quantity change of the neuron and ganglion cells of surgical resection specimens from 45 cases with HD wereobserved by HE staining which were compared with normal tissues which located the margin of tumor. The expressions of NSE and S-100 of 21 cases with HAD were analysed by IHC. Results:The heterogeneous NSE immunoreactivities of gangliocytes in knot bowelwall plexus and the evenly distributing of nerve fiber in each layer of the bowel of the control group were observed. The S-00expression of ganglion cells body showed cell shape blank areaThe differentiation abnormalities bowel the postive NSEimmunoreactivities of gangliocytes in knot bowel wall plexus and few cell shape blank areaof S00 staining were foundConelusions:The diagnosis of HAD is mainly depended on its pathologic characteristic、The IHC staining of NSE and S00 combinedwith HE stain can improve the postive rates and provide the basis of the differential diagnosis of HD and HAD
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