Section for Gastroenterology, Department of Medicine, Stord Helse-Fonna Hospital, Stord, Norway.
Mol Med Rep. 2012 Dec;6(6):1223-5. doi: 10.3892/mmr.2012.1087. Epub 2012 Sep 18.
In a previous study, chromogranin A (CgA) cell density in the colon of patients with irritable bowel syndrome (IBS) was found to be reduced. It has been suggested that intestinal CgA cell density may be used as a marker for the diagnosis of IBS. The rectum harbours a larger number of large intestinal endocrine cells and is more accessible for biopsies than the colon. The present study aimed at determining the CgA cell density in the rectum of IBS patients. A total of 47 patients with IBS that fulfilled the Rome Criteria III (39 females and 8 males; average age, 38 years) were included. A total of 28 patients had diarrhea (IBS-D) and 19 had constipation (IBS-C) as the predominant symptom. A total of 27 subjects that underwent colonoscopy with rectal biopsies were used as the controls. These subjects underwent colonoscopy due to gastrointestinal bleeding (the source of which was identified as haemorrhoids or angiodysplasia; 19 females and 8 males; average age, 49 years), or health worries. The rectal biopsies were immunostained for CgA and quantified by computer image analysis. The CgA density in the controls was 206.3±22.2 (mean ± SEM), in all IBS patients 190.2±14.3, in IBS-D patients 188.8±14.7 and in IBS-C patients 195.3±34.1. There was no statistically significant difference between the controls, IBS, IBS-D or IBS-C patients (P=0.5, 0.5 and 0.7, respectively). The present study showed that although the rectum comprises the same endocrine cell types as the colon, attention must be paid when drawing conclusions regarding the whole large intestine from studies carried out on the rectum. This particularly applies when endocrine cells are investigated. As CgA cell density represents the total endocrine cell content of the rectum, changes in specific endocrine cells in IBS patients cannot be excluded.
在之前的研究中发现，肠易激综合征（IBS）患者结肠中的嗜铬粒蛋白 A（CgA）细胞密度降低。有人提出，肠道 CgA 细胞密度可用作 IBS 的诊断标志物。直肠含有更多的大肠内分泌细胞，并且比结肠更容易进行活检。本研究旨在确定 IBS 患者直肠中的 CgA 细胞密度。共纳入 47 例符合罗马标准 III 的 IBS 患者（39 名女性和 8 名男性；平均年龄 38 岁）。共有 28 例患者以腹泻（IBS-D）为主诉，19 例以便秘（IBS-C）为主诉。共有 27 例因胃肠道出血（来源为痔疮或血管发育不良；19 名女性和 8 名男性；平均年龄 49 岁）或健康问题而行结肠镜检查并进行直肠活检的患者作为对照组。直肠活检行 CgA 免疫组化染色，并通过计算机图像分析进行定量。对照组的 CgA 密度为 206.3±22.2（平均值±SEM），所有 IBS 患者为 190.2±14.3，IBS-D 患者为 188.8±14.7，IBS-C 患者为 195.3±34.1。对照组、IBS 组、IBS-D 组和 IBS-C 组之间的 CgA 密度无统计学差异（分别为 P=0.5、0.5 和 0.7）。本研究表明，尽管直肠包含与结肠相同的内分泌细胞类型，但从直肠研究得出关于整个大肠的结论时，必须注意这一点。当研究内分泌细胞时尤其如此。由于 CgA 细胞密度代表直肠的总内分泌细胞含量，因此不能排除 IBS 患者特定内分泌细胞的变化。
