Neurogastroenterology Group, Blizard Institute of Cell and Molecular Science, Barts, Queen Mary University of London, London, UK.
Neurogastroenterol Motil. 2011 Feb;23(2):115-24. doi: 10.1111/j.1365-2982.2010.01657.x. Epub 2010 Dec 22.
Patients with gastrointestinal neuromuscular diseases may undergo operative procedures that yield tissue appropriate to diagnosis of underlying neuromuscular pathology. Critical to accurate diagnosis is the determination of limits of normality based on the study of control human tissues. Although robust diagnostic criteria exist for many qualitative alterations in the neuromuscular apparatus, these do not include quantitative values due to lack of adequate control data.
The aim of this report was to summarize all relevant available published quantitative data for elements of the human enteric nervous system (neuronal cell bodies, glial cells, and nerve fibers) from the perspective of the practicing pathologist. Forty studies meeting inclusion criteria were systematically reviewed with data tabulated in detail and discussed in the context of methodological variations and limitations. The results reveal a lack of concordance between observations of different investigators resulting in data insufficient to produce robust normal ranges. This diversity highlights the need to standardize the way pathologists collect, process, and quantitate neuronal and glial elements in enteric neuropathologic samples, as suggested by recent international guidelines on gastrointestinal neuromuscular pathology.
胃肠道神经肌肉疾病患者可能需要进行手术，以获取适合诊断潜在神经肌肉病理的组织。准确诊断的关键是基于对对照人体组织的研究来确定正常范围的界限。尽管许多神经肌肉装置的定性改变都有明确的诊断标准，但由于缺乏足够的对照数据，这些标准不包括定量值。
本报告的目的是从病理医生的角度总结所有可获得的有关人类肠神经系统（神经元细胞体、神经胶质细胞和神经纤维）的相关已发表的定量数据。系统回顾了符合纳入标准的 40 项研究，详细列出数据并结合方法学差异和局限性进行讨论。结果表明，不同研究者的观察结果不一致，导致数据不足以产生可靠的正常范围。这种多样性突出表明需要标准化病理学家收集、处理和定量肠神经病理样本中神经元和神经胶质元素的方式，正如最近关于胃肠道神经肌肉病理学的国际指南所建议的那样。
