Prişcă Radu-Alexandru, Loghin Andrada, Gozar Horea-Gheorghe, Moldovan Cosmin, Moso Tekla, Derzsi Zoltan, Borda Angela
Department of Pediatric Surgery and Orthopedics, University of Medicine and Pharmacy Tirgu-Mures, TIRGU MURES, ROMANIA.
Turk Patoloji Derg. 2014;30(2):100-4. doi: 10.5146/tjpath.2014.01242.
The mechanism by which the ureter propels urine towards the bladder has a myogenic origin, through peristaltic contractions. This pyeloureteral autorhythmicity is generated by specialized, electrically active cells, the interstitial cells of Cajal, located in the proximal regions of the upper urinary tract. The aim of this study was to describe the exact location and the distribution of interstitial Cajal cells in the human upper urinary tract and to analyze their normal number and morphology. This is a preliminary study, which will allow the study of these cells in different urinary tract pathologies.
Urinary tract fragments were sampled at different levels, from 13 autopsy cases. Cases with clinical evidence of renal disease, and with histological changes in the kidney or in the urinary tract tissue samples, visible in hematoxylin-eosin staining, were excluded. The interstitial Cajal cells were highlighted with anti-CD117 antibody, immunohistochemically.
Cajal cells were indirectly highlighted by the presence of a finely granulated cytoplasm indicating immunoreactivity. These cells were spindle-shaped or stellate, with cytoplasmic extensions at one or both poles of the cell and large oval nucleus. We found that interstitial Cajal cells were located at all upper urinary tract levels, with a higher predominance in the calyces and pyelon. Interstitial Cajal cells were observed mostly between the two layers of the muscularis, but also between the muscle bundles. Most often, these cells were parallel to the muscle fibers.
Our study describes the method of detection of interstitial Cajal cells in normal human urinary tract. These results can be used to analyze the number, morphology and the location of these cells in different congenital pathologies, such as vesicoureteral reflux, pyeloureteral junction obstruction or primary obstructive megaureter.
输尿管将尿液推向膀胱的机制起源于肌源性，通过蠕动收缩实现。这种肾盂输尿管的自动节律性是由位于上尿路近端区域的特化电活动细胞—— Cajal间质细胞产生的。本研究的目的是描述Cajal间质细胞在人类上尿路中的精确位置和分布，并分析其正常数量和形态。这是一项初步研究，将有助于在不同尿路病理情况下研究这些细胞。
从13例尸检病例中在不同水平采集尿路组织碎片。排除有肾脏疾病临床证据以及在苏木精-伊红染色中可见肾脏或尿路组织样本有组织学改变的病例。通过免疫组织化学用抗CD117抗体突出显示Cajal间质细胞。
Cajal细胞通过存在显示免疫反应性的细颗粒状细胞质而被间接突出显示。这些细胞呈纺锤形或星状，在细胞的一极或两极有细胞质延伸，细胞核大且呈椭圆形。我们发现Cajal间质细胞存在于上尿路的所有水平，在肾盏和肾盂中更为多见。Cajal间质细胞大多位于肌层的两层之间，但也存在于肌束之间。这些细胞最常与肌纤维平行。
我们的研究描述了在正常人类尿路中检测Cajal间质细胞的方法。这些结果可用于分析这些细胞在不同先天性病理情况中的数量、形态和位置，如膀胱输尿管反流、肾盂输尿管连接部梗阻或原发性梗阻性巨输尿管。
