Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, 1-1 Hasama, Yufu-city, Oita 879-5593, Japan.
Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, 1-1 Hasama, Yufu-city, Oita 879-5593, Japan; Faculty of Engineering, University of Toyama, 3190 Gofuku, Toyama-city, Toyama 930-8555, Japan.
J Pediatr Surg. 2021 Jul;56(7):1150-1156. doi: 10.1016/j.jpedsurg.2021.03.040. Epub 2021 Mar 26.
Hirschsprung disease (HSCR) is characterized by the absence of an enteric nerve system (ENS). To remove aganglionosis, bowel reconstruction is only a curative treatment. It is mandatory to identify the extent of aganglionosis during surgery. Raman spectroscopy is a nondestructive chemical analysis technique that provides detailed information regarding molecular vibrations. The purpose of this study is to detect the ENS using Raman spectroscopy in the human intestine for diagnosis of HSCR.
The Raman spectra of each layer of the gastrointestinal wall were collected from surgical specimens of the human rectum. Based on collected spectral data, principal component analysis was performed to determine the ENS. Subsequently, the Raman spectra of HSCR sections were analyzed.
Molecular structures of the gastrointestinal wall were characterized by Raman spectroscopy. Raman spectroscopy could discriminate between ganglion and muscle layers, and the spectra of the border between muscle layers in the aganglionosis were collagen-associated peaks. Either absence on presence of ENS was also confirmed in HSCR material.
Label-free detection of the ENS was successfully demonstrated using Raman spectroscopy. Since this is a preliminary study, the strategy which may contribute to differentiate between ganglionic and aganglionic segments using noninvasive techniques in HSCR should be evaluated by prospective studies in near future.
先天性巨结肠(HSCR)的特征是肠神经系统(ENS)缺失。为了去除无神经节细胞区,肠重建只是一种治愈性治疗。在手术中必须确定无神经节细胞区的范围。拉曼光谱是一种无损的化学分析技术,可提供有关分子振动的详细信息。本研究旨在使用拉曼光谱术在人肠中检测 ENS,以诊断 HSCR。
从人直肠的手术标本中收集胃肠道壁各层的拉曼光谱。基于收集的光谱数据,进行主成分分析以确定 ENS。随后,分析 HSCR 切片的拉曼光谱。
拉曼光谱术可对胃肠道壁的分子结构进行特征描述。拉曼光谱术可区分神经节和肌肉层,并且无神经节细胞区肌肉层之间边界的光谱为胶原相关峰。HSCR 标本中也证实了 ENS 的缺失或存在。
使用拉曼光谱术成功地实现了对 ENS 的无标记检测。由于这是一项初步研究,因此应该通过未来的前瞻性研究来评估使用非侵入性技术区分 HSCR 中神经节和无神经节段的策略。