The Study In Clinical And Pathological Diagnosis Of Congenital Megacolon And Allied Diseases In The Methods Of Histochemical Diagnosis In Mucosal Biopsy And Immunohistochemical Labeling Of Intestinal Ganglion Cells

A new diagnostic method of mucous membrane biopsy and acetylcholinesterase staining was developed before operation. Postoperative pathologic specimens were labeled with five sorts of immunohistochemistrical reagent. At mean while, clinical data was contrasted and studied retrospectively. By the way of discussing on clinical and pathological characteristics of HD and HAD, evaluating role of those specific reagents, exploring in making method of IGCs maturity, The purpose is to know HD and HAD deeply, to increase accurate rate of preoperative and postoperative pathologic diagnosis.44 cases were diagnosised by the way of mucous membrane biopsy and acetylcholinesterase staining before operation. Pathologic diagnostic conclusions of HE divide into categorical group, doubtful group and control group, immunohistochemistrical labeling were performed in 52 cases for NSE, PGP9.5, Cathepsin D, Vimentin, NFP, to diagnosis clearly and evaluate role of those specific reagents in discerning IGCs.the data were analyzed relatively between clinic, mucous membrane biopsy, HE and immunohistochemistrical labeling, to summarize clinical and pathomorphological characteristics. Specimens from proximal colon of different ages were divided into groups and measured by micrometer, to study the relationship between Age and maturity of IGCs, the roleof those reagents in staining mature and immature IGCs.The method of mucous membrane biopsy and acetylcholinesterase staining was more accurate than others, it should be developed as one of common routine in the preoperative diagnosis, but it didn't help differential diagnosis with HD and HAD. In addition, intensity of AChE staining correlated to extent of constipation and obstruction. Although Preoperative diagnosis was very difficulty, it should be thought highly of, because more a half (55.4%) was HAD in total cases.Immunohistochemistrical staining could increase the accurate rate of pathologic diagnosis. It was thought that Cathepsin D was better one with high specificity, few interference and good effect. Conceived that Cathepsin D could be used in the preoperative diagnosis of mucous membrane biopsy. It's Significant that the age affected maturity of IGCs, increasing with age, the proportion of mature IGCs increased gradually. Age factor should be regarded in clinical and pathomorphological diagnosis. Both of PGP9.5 and Cathepsin D expressed in IGCs, immature and mature IGCs expressed different patterns, Vimentin and NFP had differential expression and varied reversely in immature and mature one, it's helpful to verdict immaturity of IGCs in combination Vimentin with NFP.