Srougi Victor, Bandeira Rodolfo Anisio Santana de Torres, Reis Sabrina Thalita, Dos Santos Gabriel Arantes, Andrade Hiury da Silva, Leite Katia Ramos Moreira, Hamilton-Cho David, Mitre Anuar Ibrahim, Arap Marco Antonio, Srougi Miguel, Duarte Ricardo Jordão
Division of Urology, University of Sao Paulo Medical School, Sao Paulo, Brazil.
Hospital Moriah, Sao Paulo, Brazil.
Urologia. 2023 Feb;90(1):30-35. doi: 10.1177/03915603221107470. Epub 2022 Jun 28.
To evaluate if the density of interstitial cells of Cajal (ICC) in the ureteropelvic junction (UPJ) influences the outcomes of pyeloplasty in adults.
Twenty-three patients with the diagnosis of ureteropelvic junction obstruction (UPJO) that underwent laparoscopic dismembered pyeloplasty were included. ICC density was measured using immunohistochemistry reaction for c-KIT expression in the resected UPJ segment. Pyeloplasty outcome was evaluated by patient self-report pain, urinary outflow using DTPA renogram and hydronephrosis assessment using ultrasound (US) at 12 months of follow-up. A logistic regression analysis was performed to assess the association of pyeloplasty outcomes and ICC density.
Low, moderate, and high ICC density were present in 17.4%, 30.4%, and 52.2% of the patients, respectively. Complete pain resolution was observed in 100%, 85.7%, and 75% of patients with low, moderate and high ICC density, respectively ( = 0.791). DTPA renogram improved in 75%, 85.7%, and 91.7% of patients with low, moderate and high ICC density, respectively ( = 0.739). Hydronephrosis improved in 25%, 85.7%, and 91.7% of patients with low, moderate and high ICC density, respectively ( = 0.032).
Patients with high ICC density have a significant amelioration of hydronephrosis after pyeloplasty. However, ICC density is not associated with functional outcomes.
评估成人肾盂输尿管连接部（UPJ）中 Cajal 间质细胞（ICC）的密度是否会影响肾盂成形术的效果。
纳入 23 例诊断为肾盂输尿管连接部梗阻（UPJO）并接受腹腔镜离断性肾盂成形术的患者。使用免疫组织化学反应检测切除的 UPJ 段中 c-KIT 的表达，以测量 ICC 密度。在随访 12 个月时，通过患者自我报告疼痛、使用二巯基丁二酸（DTPA）肾图评估尿流情况以及使用超声（US）评估肾积水情况来评估肾盂成形术的效果。进行逻辑回归分析以评估肾盂成形术效果与 ICC 密度之间的关联。
ICC 密度低、中、高的患者分别占 17.4%、30.4%和 52.2%。ICC 密度低、中、高的患者中，分别有 100%、85.7%和 75%的患者疼痛完全缓解（P = 0.791）。DTPA 肾图改善的患者在 ICC 密度低、中、高的患者中分别占 75%、85.7%和 91.7%（P = 0.739）。肾积水改善的患者在 ICC 密度低、中、高的患者中分别占 25%、85.7%和 91.7%（P = 0.032）。
ICC 密度高的患者在肾盂成形术后肾积水有明显改善。然而，ICC 密度与功能结局无关。
