Yan Ma, Jizhen Zou, Ping Xiao, Cheng Huang, Dongsheng Bai
Department of Urology, Children's Hospital, Capital Institute of Pediatrics, Beijing, China.
Department of Pathology, Children's Hospital, Capital Institute of Pediatrics, Beijing, China.
Front Pediatr. 2024 Jul 23;12:1416789. doi: 10.3389/fped.2024.1416789. eCollection 2024.
To analyze from a pathological perspective the differences between intermittent and persistent hydronephrosis in children with uretero-pelvic junction obstruction.
23 children who underwent unilateral dismembered pyeloplasty (Anderson-Hynes operation) for intermittent hydronephrosis from September 2017 to March 2024 were included in the observation group. They were compared with a control group consisting of 23 children with persistent hydronephrosis matched for age, gender, and affected side. All children had the narrowed segment surgically excised during the operation, while other obstructive causes (such as polyps, crossing vessels, or tumor compression) were excluded. The specimens were analyzed for muscle and collagen content using Masson's trichrome staining, and the collagen-to-muscle ratio (CMR) was calculated. The number of Cajal-like cells was quantified with c-kit immunohistochemical staining. For all slides, 10 random fields of view were selected under a 400× optical microscope to record pathological data and calculate mean values. Pathological indicators between the two groups were compared using the -test and the Chi-square test, with < 0.05 considered statistically significant.
The observation group showed a significant difference in the number of fields with low, medium, and high densities of Cajal-like cells compared to the control group [132 (57.4%) vs. 173 (75.2%); 70 (30.4%) vs. 38 (16.5%); 28(12.2%) vs. 19 (8.3%), < 0.001]. The uretero-pelvic junction in children with intermittent hydronephrosis had lower collagen content, higher muscle content, and a more regular arrangement. The collagen-muscle ratio was significantly lower than that in children with persistent hydronephrosis [(1.59 ± 0.65) vs. (3.98 ± 1.19), < 0.001].
Compared with persistent hydronephrosis, the narrowed segment at the uretero-pelvic junction in children with intermittent hydronephrosis has a higher density of Cajal-like cells; lower collagen content, and higher muscle content (lower collagen-muscle ratio).
从病理学角度分析输尿管肾盂连接部梗阻患儿间歇性肾积水与持续性肾积水的差异。
选取2017年9月至2024年3月期间因间歇性肾积水接受单侧离断性肾盂成形术（安德森-海恩斯手术）的23例患儿作为观察组。将其与由23例年龄、性别及患侧匹配的持续性肾积水患儿组成的对照组进行比较。所有患儿在手术中均切除狭窄段，同时排除其他梗阻原因（如息肉、交叉血管或肿瘤压迫）。采用Masson三色染色法分析标本的肌肉和胶原含量，并计算胶原与肌肉比值（CMR）。用c-kit免疫组织化学染色定量Cajal样细胞数量。在400倍光学显微镜下，为所有切片随机选取10个视野记录病理数据并计算平均值。两组间病理指标采用t检验和卡方检验进行比较，P<0.05认为差异有统计学意义。
观察组与对照组相比，Cajal样细胞低密度、中密度和高密度视野数量存在显著差异[132（57.4%）对173（75.2%）；70（30.4%）对38（16.5%）；28（12.2%）对19（8.3%），P<0.001]。间歇性肾积水患儿的输尿管肾盂连接部胶原含量较低，肌肉含量较高，排列更规则。胶原-肌肉比值显著低于持续性肾积水患儿[（1.59±0.65）对（3.98±1.19），P<0.001]。
与持续性肾积水相比，间歇性肾积水患儿输尿管肾盂连接部狭窄段Cajal样细胞密度更高；胶原含量更低，肌肉含量更高（胶原-肌肉比值更低）。
