Zhang Li, Yang Bin, Zhang Yu-Chao, Fu Yu-Ru, Chen Shuang
Department of Gastrointestinal Surgery, The Second Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.
Zhonghua Wai Ke Za Zhi. 2009 Jun 15;47(12):912-5.
To investigate the histomorphological characteristics and its significance of rectum wall above hemorrhoids.
Tissues of rectum wall above hemorrhoids were obtained after stapled hemorrhoidopexy from 21 patients with grade III-IV internal hemorrhoids. Seven macroscopically normal rectal tissues collected from upper rectal cancer patients without a history of hemorrhoids served as control. Masson trichrome staining was performed for detecting smooth muscles and collagen in the tissues. The expression of type III collagen was detected by using immunohistochemical staining in the two groups.
Morphological abnormalities, such as fragment, rupture, disorganization were found in smooth muscle of proximal rectal tissues above the piles, and it was statistically different from the distal rectal tissues above the piles and control tissues (all P < 0.05). Moreover, hyperplasia of type III collagen in both muscularis mucosa and rectum wall in tissues above hemorrhoids were observed, no such changes was found in the control tissues.
The range of pathological changes in hemorrhoids is beyond the anal cushions. The pathological changes of the smooth muscle and the type III collagen in the tissues above the piles are the pathological basis of hemorrhoids.
探讨痔上方直肠壁的组织形态学特征及其意义。
对21例III-IV度内痔患者行吻合器痔上黏膜环切术,获取痔上方直肠壁组织。收集7例无痔病史的上段直肠癌患者的宏观正常直肠组织作为对照。采用Masson三色染色法检测组织中的平滑肌和胶原。采用免疫组织化学染色法检测两组中III型胶原的表达。
痔上方近端直肠组织的平滑肌出现形态学异常,如断裂、破碎、排列紊乱,与痔上方远端直肠组织及对照组织相比差异有统计学意义(均P<0.05)。此外,观察到痔上方组织的黏膜肌层和直肠壁中III型胶原增生,对照组织未发现此类变化。
痔的病理变化范围超出肛垫。痔上方组织中平滑肌和III型胶原的病理变化是痔的病理基础。