摘要
目的进一步观察隔膜组织的确切形态和其内神经节细胞发育情况,为液泡上皮细胞和间充质细胞参与形成隔膜组织提供形态学依据。方法选I型空肠闭锁患儿,术中切除闭锁肠段,沿闭锁肠管纵轴进行组织切片,常规苏木精-伊红染色和免疫组织化学染色,采用数字切片扫描系统扫描载玻片并进行图片观察、采集。结果隔膜两侧被覆肠管黏膜,具备完整的上皮层、固有层和黏膜肌层。黏膜分别来源于隔膜组织远、近端肠腔黏膜组织,隔膜中央为黏膜下层组织,与肠壁黏膜下层相延续。肠壁肌层贴近隔膜组织向远端走行,未向隔膜组织内延续。免疫组织化学染色显示邻近正常肠壁黏膜下层、内侧环肌和外侧纵肌之间以及隔膜内散在蛋白基因产物9.5(PGP9.5)和配对同源异型盒蛋白2B(PHOX2B)阳性表达,隔膜组织和邻近肠壁黏膜下层内的神经节细胞相互延续。结论隔膜主要由黏膜下层组织构成并与邻近正常肠壁黏膜下层延续,其两侧被覆黏膜。隔膜内存在神经节细胞发育,并且与邻近正常肠壁黏膜下层神经节细胞走行延续。胚胎期液泡上皮细胞和间充质细胞参与了隔膜组织的形成。
Objective To further observe the exact morphology of the jejunal atresia and the development of ganglion cells within it,thus providing morphological reference for the involvement of vacuolar epithelial cells and mesenchymal cells in forming the diaphragm.Methods The segment of jejunal atresia was intraoperatively harvested from a child with type I jejunal atresia.Tissue sections were prepared along the longitudinal axis of the jejunal atresia for hematoxylin and eosin(H&E)and immunohistochemical staining.Images were captured by scanning tissue slices using the digital section system.Results Bilateral sides of the jejunal atresia were covered by intestinal mucosa,with complete epithelial layer,propria and muscularis mucosae.The mucosa derived from the distal and proximal intestinal mucosa of the diaphragm,where the submucosal tissue situated in the center and continued with the submucosal layer of the intestinal wall.The muscle layer of the intestinal wall traveled distally close to the diaphragm,without a further disclosure into the diaphragm.Immunohistochemical staining showed positive expressions of PGP9.5 and PHOX2B adjacent to the normal intestinal wall,between the medial ring and lateral longitudinal muscles,and in the septal membrane.Ganglion cells in the adjacent intestinal wall continued with each other.Conclusions The jejunal atresia is mainly composed of submucosal tissue and continues with the submucosal layer adjacent to the normal intestinal wall,where the bilateral sides are covered with mucosa.Ganglion cells develop in the diaphragm and continue with those adjacent to the submucosal layer of the normal intestinal wall.Vacuum epithelial cells and mesenchymal cells are involved in the formation of jejunal atresia.
作者
刘雪来
王欢
何峰
叶茂
陈钰嫱
Liu Xuelai;Wang Huan;He Feng;Ye Mao;Chen Yuqiang(Department of General Surgery,Capital Center for Children's Health,Capital Medical Univerisity,Beijing 100020,China;Department of Pathology,Heilongjiang Hospital,Beijing Children's Hospital,Capital Medical University,Heilongjiang Harbin 150010,China;Department of Biochemistry and Immunology,Capital Institute of Pediatrics,Beijing 100020,China)
出处
《腹部外科》
2025年第3期175-179,共5页
Journal of Abdominal Surgery
基金
北京市自然科学基金面上项目(7222015)
首都儿科研究所2023年度临床研究培育专项(LCYJ-2023-07)
黑龙江省卫生健康委员会基金(2020-043)
2024-2025年北京市卫生健康委员会“一带一路”卫生健康国际合作项目和世界卫生组织合作中心项目。
关键词
肠闭锁
隔膜组织
黏膜下层
神经节细胞
Intestinal atresia
Septa
Submucosal layers
Ganglion cells
