Shangjie Xiao, Xiaochun Zhu, Wenyi Yang, Wuping Ge, Ying Zhang, Qiuming He, Huimin Xia
Southern Medical University, Guangzhou, 510515, Guangdong, China.
Cell Biochem Biophys. 2015 Mar;71(2):1249-54. doi: 10.1007/s12013-014-0338-1.
The study was set to analyze the predictive values of transforming growth factor β1 (TGF-β1), Ghrelin, Neurexin, and Neuroligin protein expression on postoperative prognosis of laparoscopic surgery in children with Hirschsprung disease. 281 cases of children with Hirschsprung disease, admitted into Guangdong Women and Children Hospital and Guangzhou women and children's medical center from March 2009 to March 2014, were treated with laparoscopic radical surgery for Hirschsprung disease. They were divided into the good and the poor prognosis groups according to their recuperation and complications. Protein expressions of TGF-β1, Ghrelin, Neurexin, and Neuroligin were prospectively analyzed. The correlations between the expressions of these proteins and the prognosis were analyzed. There were 129 cases of children with poor prognosis, accounting for 45.9 %. There were no significant differences in the expressions of TGF-β1 mRNA and proteins within the group in both the groups (p > 0.05). TGF-β1 mRNA and protein expressions of the poor prognosis group were significantly higher than those of the good prognosis group in each segment of intestine (p < 0.05). Protein detection results manifested that Ghrelin protein expression gradually increased along narrow segment, transitional segment, and expansion segment in both groups. Ghrelin protein expression of the poor prognosis group was significantly lower than that of the good prognosis group in each segment of intestine (p < 0.05). There were significant differences in the protein expressions of Neurexin and Neuroligin within the group. The protein expressions of Neurexin and Neuroligin in expansion segment were the highest. Neurexin and Neuroligin protein expressions of the poor prognosis group were significantly lower than those of the good prognosis group in each segment of intestine (p < 0.05). Increasing expression of TGF-β1 protein, decreasing expressions of Ghrelin, Neurexin, and Neuroligin proteins can induce the loss or dysfunction of ganglion cells in distal intestinal canal, which is closely correlated with the occurrences of adverse prognosis, such as increased intestinal peristalsis recovery time, increased complication rate etc., in children. It has a high value for predicting prognosis of children patients with Hirschsprung disease after surgical intervention.
本研究旨在分析转化生长因子β1（TGF-β1）、胃饥饿素、接触蛋白及神经连接蛋白的蛋白表达对先天性巨结肠症患儿腹腔镜手术后预后的预测价值。选取2009年3月至2014年3月在广东省妇幼保健院及广州市妇女儿童医疗中心收治的281例先天性巨结肠症患儿，均接受腹腔镜根治性手术治疗。根据术后恢复情况及并发症情况分为预后良好组和预后不良组，前瞻性分析TGF-β1、胃饥饿素、接触蛋白及神经连接蛋白的蛋白表达情况，并分析这些蛋白表达与预后的相关性。预后不良患儿129例，占45.9%。两组TGF-β1 mRNA及蛋白表达组内比较差异均无统计学意义（p＞0.05），各肠段预后不良组TGF-β1 mRNA及蛋白表达均显著高于预后良好组（p＜0.05）。蛋白检测结果显示，两组胃饥饿素蛋白表达均沿狭窄段、移行段、扩张段逐渐升高，各肠段预后不良组胃饥饿素蛋白表达均显著低于预后良好组（p＜0.05）。两组接触蛋白及神经连接蛋白的蛋白表达组内比较差异均有统计学意义，扩张段接触蛋白及神经连接蛋白的蛋白表达最高，各肠段预后不良组接触蛋白及神经连接蛋白的蛋白表达均显著低于预后良好组（p＜0.05）。TGF-β1蛋白表达升高、胃饥饿素、接触蛋白及神经连接蛋白蛋白表达降低可导致远端肠道神经节细胞缺失或功能障碍，与患儿术后肠道蠕动恢复时间延长、并发症发生率升高等不良预后的发生密切相关，对预测先天性巨结肠症患儿手术干预后的预后具有较高价值。
