HAND2、组织蛋白酶D在先天性胆总管扩张症中的表达及其意义-现代医学

HAND2、组织蛋白酶D在先天性胆总管扩张症中的表达及其意义

单位：菏泽市立医院小儿外科, 山东菏泽 274000

分类号：R725.7

出版年·卷·期（页码）：2020·48·第十二期（1593-1598）

摘要：

目的： 探讨心脏神经脊衍生物表达转录因子2（HAND2）、组织蛋白酶D （Cath-D）在先天性胆总管扩张症（CBD）中的表达及其意义。方法： 选取我院2014年5月至2019年3月小儿外科收治的CBD患儿38例，另切取12例意外终止妊娠患儿胆囊壁和胆管壁为对照组。采用免疫组织化学方法检测两组患儿胆道组织HAND2、Cath-D表达情况。结果： 与对照组比较，CBD患者胆囊壁、胆管壁HAND2、Cath-D表达阳性率降低，差异有统计学意义（P<0.05）。Todani分型Ⅰ、Ⅱ和Ⅳ型组间HAND2、Cath-D表达阳性率差异有统计学意义（P<0.05）。胆管壁与胆囊壁HAND2、Cath-D表达随着黏膜细胞脱落的严重程度、管壁的增生和肥厚程度，以及炎症细胞浸润程度的加重而降低（P<0.05），但不同损伤类型的胆管壁与胆囊壁黏膜上皮细胞假复层排列和脱落上皮部分肉芽组织替代比较，差异无统计学意义（P>0.05）。HAND2、Cath-D在CBD胆管壁及胆囊壁的表达与炎症细胞浸润程度呈负相关（均P<0.05）。结论： HAND2、Cath-D在CBD患者胆道组织中表达明显降低，可辅助判断患者病情。

Objective: To discuss the expression and value of heart and neural crest derivatives-expressed transcript 2(HAND2) and cathepsin D(Cath-D) in congenital biliary dilatation(CBD). Methods: Biliary tissue from 38 cases of CBD patients admitted to pediatric surgery from May 2014 to March 2019 were collected. Taken the gallbladder and bile duct tissues from 12 unexpected pregnancy termination as control group. HAND2 and Cath-D expression were evaluated by immunohistochemistry. Results: Compared with control group,HAND2 and Cath-D expression in the gallbladder and bile ductwere reduced in CBD group(P<0.05). There was a statistically significant difference in the positive rate of HAND2 and Cath-D among Todani type Ⅰ, Ⅱ and Ⅳ groups(P<0.05). HAND2, Cath-D expression in bile ductand the gallbladderwere different in the severity of mucosal cell apoptosis, the proliferation and hypertrophy of the duct, and the aggravation of inflammatory cell infiltration(P<0.05). But there were no significant difference in the pseudo-stratified distribution of mucosal epithelial cells and the replacement of granulation tissue in the replacement epithelium(P>0.05). The expression of HAND2 and Cath-D in CBD bile ductand gallbladder were negatively correlated with the degree of respiratory cell infiltration(P<0.05).Conclusion: The expression of HAND2 and Cath-D in patients with CBD were significantly reduced, which could assist in evaluating the degree of bile duct damage.

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