Tissue samples of the lower esophageal sphincter (LES) high-pressure zone were obtained from 27 achalasia patients and 10 controls. Immunohistochemistry for MMφ, interstitial cells of Cajal (ICC), neuronal nitric oxide synthase (nNOS), and glial cells were conducted. Histological characteristics were compared between groups, and correlation analysis was performed.
Fewer ICC was found in achalasia compared with controls (P = 0.018), and the level of M1 macrophages was higher than that in controls no matter in terms of the number or the proportion of M1(P = 0.026 for M1 and 0.037 for M1/MMφ). Statistical differences were found between two groups in terms of proportion of M2 and ratio of M1 to M2 (P = 0.048 for M2/ MMφ and < 0.001 for M1/M2). For the correlation analysis, significant correlations were detected between levels of nNOS, ICC, and glial cells in patients with achalasia (P = 0.026 for nNOS and ICC, 0.001 for nNOS and glial cells, 0.019 for ICC and glial cells). There were significant correlations between M2/MMφ and levels of ICC (P = 0.019), glial cells (P = 0.004), and nNOS (P = 0.135).
Patients with achalasia had a higher level of M1/M2 ratio in LES and significant correlations were found between M2/MMφ and numbers of ICC and glial cells, which suggested that MMφ were probably associated with occurrence and development of achalasia.
方法:从27例贲门失弛缓症患者和10例对照中获取食管下括约肌(LES)高压区组织样本。MMφ的免疫组织化学,Cajal间质细胞(ICC),神经元型一氧化氮合酶(nNOS),和神经胶质细胞进行。组间比较组织学特征,并进行相关性分析。
结果:与对照组相比,门失弛缓症中发现的ICC较少(P=0.018),无论M1的数量或比例,M1巨噬细胞的水平均高于对照组(M1的P=0.026,M1/MMφ的P=0.037)。在M2的比例和M1与M2的比例方面,两组之间存在统计学差异(M2/MMφP=0.048,M1/M2<0.001)。对于相关性分析,检测到nNOS水平之间存在显著相关性,ICC,失弛缓症患者的神经胶质细胞(nNOS和ICC的P=0.026,nNOS和神经胶质细胞为0.001,0.019对于ICC和神经胶质细胞)。M2/MMφ与ICC水平呈显著相关(P=0.019),胶质细胞(P=0.004),和nNOS(P=0.135)。
结论:门失弛缓症患者在LES中M1/M2比值较高,M2/MMφ与ICC和胶质细胞数量之间存在显着相关性。这表明MMφ可能与贲门失弛缓症的发生发展有关。