Research In Distributions Of Ganglia And Cajal Cells In The Distal Rectum Walls With Congenital Imperforate Anus

Objective:Anorectal malformation is a kind of most common congenital anomalies. The most frequent post-operative complication encountered after treatment is the functional disorders of defecation, incontinence, constipation, for instance, of which the incidence is 10-75%. Defecation receptor is an essential part of defecation reflex process, was confirmed distributing in rectum, mucous membrane of anal canal, external anal sphincter and muscle of pelvic cavity. And it has been showed that the Cajal cells were pacemaker cells and stretch receptors in a certain part of intestinal tract, so that absence of the Cajal cells should result in defecation disorders, which has been confirmed in the study of Hirschsprung's Disease. The objective is investigating the distribution of nerve plexus, ganglion cells and Cajal cells in the distal rectum walls with Congenital Imperforate Anus and the significance.Methods:HE staining and immunohistochemical analysis of samples from patients with congenital imperforate anus were done for ganglia, myenteric plexuses, Cajal cells, NSE, S-100 and c-kit.Results: HE staining showed us that mucous membrane tissue covered with squamous epithelium was found in Meissnar's plexus in low-position imperforate anus. And we also found annuliform muscle, longitudinal muscle and nerves plexus included in. Some samples have several ganglion cells, and some have no ganglia completely. And HE staining showed us that the nerve plexus in high position imperforate anus was fewer than that in low-position imperforate anus, and part of mucous membrane tissue, annuliform muscle and longitudinal muscle in high position imperforate anus.We can find S-100 positive nerve plexus and nerve fiber both in low and high position imperforate anus samples. A significantly higher proportion of myenteric plexuses and neuroplex positive expression in low-position imperforate anus was more than that in high position imperforate anus. There was no ganglion cells positive expression in high position imperforate anus. Obvious ganglion cells were found in 6 low-position samples.We can see 1-4 cells in a plexus approximately. And c-kit positive expression weren't found in high position imperforate anus. These samples showed that the nerve plexus were slender, and the ganglion cells were decreased or absent. A significantly higher proportion of NSE-positive and c-kit positive expression was more in low-position imperforate anus than that in high position imperforate anus (P<0.05).Conclusion:It has showed that some ganglion cells was appeared in rectum wall with CIA. But a large part of samples have no ganglion cells in rectum, and the Cajal cells may not appear in rectum wall. However, ganglion cells, nerve plexus and Cajal cells in low-position imperforate anus are more than that in high position imperforate anus. The intestinal tract motivation was concerned with Cajal cells and ganglion cells. So absence of them should result in the intestinal tract motivation disorder. In summary, the intestinal tract motivation was concerned with Cajal cells, ganglion cells and nerve plexus. There were less Cajal cells and ganglion cells in low-position imperforate anus group and high-position imperforate anus group than that in the control group, which may affect the intestinal tract motivation resulted in functional disorders of defecation.