PDF(Pubmed)
Abstract：
BACKGROUND: Congenital inguinal hernia, hydrocele and undescended testis (UDT) are associated with patent processus vaginalis. The smooth muscles present in the processus vaginalis aid in the descent of the testis and undergo programmed cell death after testicular descent leading to obliteration. The persisting amount of smooth muscle in the processus vaginalis influences the clinical outcome as inguinal hernia, hydrocele or UDT. Therefore, a study was conducted to evaluate the processus vaginalis in these three conditions to observe the presence and phenotype of smooth muscle cells and the presence of myofibroblasts.
METHODS: The processus vaginalis sacs in patients with inguinal hernia, hydrocele and UDT were examined using light microscopy for the presence and distribution of smooth muscle cells and immunohistochemical staining for vimentin, desmin, and α-smooth muscle actin (SMA) to identify the smooth muscle phenotype. Transmission electron microscopy was also performed in all the sacs to observe the presence of myofibroblasts.
RESULTS: Seventy-eight specimens of processus vaginalis (from seventy-four patients), distributed as 47%, 27%, and 26% as inguinal hernia, hydrocele and UDT respectively, were included in the study. The sacs from inguinal hernia and hydrocele had significantly more presence of smooth muscles distributed as multiple smooth muscle bundles (p < 0.001). Desmin and SMA staining of smooth muscle cells was observed in significantly more sacs from hydrocele, followed by inguinal hernia and UDT (p < 0.001). The sacs from UDT had a significant presence of striated muscles (p = 0.028). The sacs from inguinal hernia had a significant presence of myofibroblasts, followed by hydrocele and UDT (p < 0.001) and this significantly correlated with the light microscopy and immunohistochemical features. The processus vaginalis sacs from four female patients did not differ statistically from the male inguinal hernia sacs in any of the above parameters.
CONCLUSIONS: The processus vaginalis sacs in pediatric inguinal hernia, hydrocele and undescended testis differ in the presence, distribution and phenotype of smooth muscles and the presence of myofibroblasts. The clinical presentations in these entities reflect these differences.
METHODS: The processus vaginalis sacs in patients with inguinal hernia, hydrocele and UDT were examined using light microscopy for the presence and distribution of smooth muscle cells and immunohistochemical staining for vimentin, desmin, and α-smooth muscle actin (SMA) to identify the smooth muscle phenotype. Transmission electron microscopy was also performed in all the sacs to observe the presence of myofibroblasts.
RESULTS: Seventy-eight specimens of processus vaginalis (from seventy-four patients), distributed as 47%, 27%, and 26% as inguinal hernia, hydrocele and UDT respectively, were included in the study. The sacs from inguinal hernia and hydrocele had significantly more presence of smooth muscles distributed as multiple smooth muscle bundles (p < 0.001). Desmin and SMA staining of smooth muscle cells was observed in significantly more sacs from hydrocele, followed by inguinal hernia and UDT (p < 0.001). The sacs from UDT had a significant presence of striated muscles (p = 0.028). The sacs from inguinal hernia had a significant presence of myofibroblasts, followed by hydrocele and UDT (p < 0.001) and this significantly correlated with the light microscopy and immunohistochemical features. The processus vaginalis sacs from four female patients did not differ statistically from the male inguinal hernia sacs in any of the above parameters.
CONCLUSIONS: The processus vaginalis sacs in pediatric inguinal hernia, hydrocele and undescended testis differ in the presence, distribution and phenotype of smooth muscles and the presence of myofibroblasts. The clinical presentations in these entities reflect these differences.
摘要：
背景：先天性腹股沟疝，鞘膜积液和隐睾（UDT）与阴道未闭有关。阴道毛突中存在的平滑肌有助于睾丸的下降，并在睾丸下降后发生程序性细胞死亡，导致闭塞。作为腹股沟疝，阴道突持续的平滑肌量会影响临床结局，鞘膜积液或UDT。因此,在这三种情况下，进行了一项研究来评估阴道突，以观察平滑肌细胞的存在和表型以及肌成纤维细胞的存在。
方法：腹股沟疝患者的阴道前囊，使用光学显微镜检查鞘膜积液和UDT的平滑肌细胞的存在和分布以及波形蛋白的免疫组织化学染色，desmin,和α-平滑肌肌动蛋白(SMA)来鉴定平滑肌表型。还在所有囊中进行透射电子显微镜以观察肌成纤维细胞的存在。
结果：78个阴道突组织标本（来自74个患者），分布为47%，27%,26%为腹股沟疝,分别为鞘膜积液和UDT,包括在研究中。来自腹股沟疝和鞘膜积液的囊明显存在更多的平滑肌，分布为多个平滑肌束（p<0.001）。在明显更多的鞘膜积液囊中观察到平滑肌细胞的Desmin和SMA染色，其次是腹股沟疝和UDT（p<0.001）。来自UDT的囊具有显著存在的横纹肌(p=0.028)。腹股沟疝的囊有明显的肌成纤维细胞，其次是鞘膜积液和UDT（p<0.001），这与光学显微镜和免疫组织化学特征显着相关。在上述任何参数中，来自四名女性患者的阴道囊与男性腹股沟疝囊在统计学上都没有差异。
结论：小儿腹股沟疝的阴道前囊，鞘膜积液和未降睾丸的存在不同，平滑肌的分布和表型以及肌成纤维细胞的存在。这些实体的临床表现反映了这些差异。
方法：腹股沟疝患者的阴道前囊，使用光学显微镜检查鞘膜积液和UDT的平滑肌细胞的存在和分布以及波形蛋白的免疫组织化学染色，desmin,和α-平滑肌肌动蛋白(SMA)来鉴定平滑肌表型。还在所有囊中进行透射电子显微镜以观察肌成纤维细胞的存在。
结果：78个阴道突组织标本（来自74个患者），分布为47%，27%,26%为腹股沟疝,分别为鞘膜积液和UDT,包括在研究中。来自腹股沟疝和鞘膜积液的囊明显存在更多的平滑肌，分布为多个平滑肌束（p<0.001）。在明显更多的鞘膜积液囊中观察到平滑肌细胞的Desmin和SMA染色，其次是腹股沟疝和UDT（p<0.001）。来自UDT的囊具有显著存在的横纹肌(p=0.028)。腹股沟疝的囊有明显的肌成纤维细胞，其次是鞘膜积液和UDT（p<0.001），这与光学显微镜和免疫组织化学特征显着相关。在上述任何参数中，来自四名女性患者的阴道囊与男性腹股沟疝囊在统计学上都没有差异。
结论：小儿腹股沟疝的阴道前囊，鞘膜积液和未降睾丸的存在不同，平滑肌的分布和表型以及肌成纤维细胞的存在。这些实体的临床表现反映了这些差异。
