TY - JOUR
T1 - Decreased Interstitial Cells of Cajal-like Cells, Possible Cause of Congenital Refluxing Megaureters
T2 - Histopathologic Differences in Refluxing and Obstructive Megaureters
AU - Kang, Hyo Jin
AU - Lee, Hye Young
AU - Jin, Mei Hua
AU - Jeong, Hyeon Joo
AU - Han, Sang Won
PY - 2009/8
Y1 - 2009/8
N2 - Objectives: To evaluate the location of interstitial cells of Cajal-like cells and the ureteral aspect using histopathologic studies of obstructive and refluxing megaureters to reveal the different pathogenesis of megaureters in the human urinary tract. The underlying pathophysiology of obstructive megaureter and refluxing megaureter is poorly understood. Methods: The data from 14 patients with obstructive megaureter (7 boys and 7 girls), with a mean age of 12 months (range 2-84), and 9 patients with refluxing megaureter (7 boys and 2 girls), with a mean age of 11 months (range 4-24), were compared. We investigated the difference in the histopathologic aspects using Masson's trichrome, terminal uridine deoxynucleotidyl transferase dUTP nick end labeling (for apoptosis), and human c-kit antibody (CD117 for interstitial cells of Cajal-like cells) between the obstructive and refluxing megaureters. Results: The proportion of smooth muscle was significantly lower in segments of refluxing megaureter (32.04% ± 4.96%) than in the segments of obstructive megaureter (52.48% ± 3.46%; P < .01). The number of apoptotic cells was significantly increased in the obstructive megaureter (mean 1661 ± 135.1 cells) compared with the refluxing megaureter (mean 375.2 ± 65.14 cells; P < .0001). The number of c-kit positive cells was significantly lower in the refluxing megaureter (mean 83.60 ± 48.84 cells) than in the obstructive megaureter (mean 463.6 ± 100.4 cells; P < .05). Conclusions: The differences in the histopathologic aspects can provide information on the possible pathophysiology of obstructive and refluxing megaureters. Ureteral peristalsis can be affected by the increased myocyte apoptosis in the obstructive megaureter and by the decreased number of interstitial cells of Cajal-like cells and smooth muscle content in refluxing megaureters. Additional research is warranted to elucidate the exact pathophysiology.
AB - Objectives: To evaluate the location of interstitial cells of Cajal-like cells and the ureteral aspect using histopathologic studies of obstructive and refluxing megaureters to reveal the different pathogenesis of megaureters in the human urinary tract. The underlying pathophysiology of obstructive megaureter and refluxing megaureter is poorly understood. Methods: The data from 14 patients with obstructive megaureter (7 boys and 7 girls), with a mean age of 12 months (range 2-84), and 9 patients with refluxing megaureter (7 boys and 2 girls), with a mean age of 11 months (range 4-24), were compared. We investigated the difference in the histopathologic aspects using Masson's trichrome, terminal uridine deoxynucleotidyl transferase dUTP nick end labeling (for apoptosis), and human c-kit antibody (CD117 for interstitial cells of Cajal-like cells) between the obstructive and refluxing megaureters. Results: The proportion of smooth muscle was significantly lower in segments of refluxing megaureter (32.04% ± 4.96%) than in the segments of obstructive megaureter (52.48% ± 3.46%; P < .01). The number of apoptotic cells was significantly increased in the obstructive megaureter (mean 1661 ± 135.1 cells) compared with the refluxing megaureter (mean 375.2 ± 65.14 cells; P < .0001). The number of c-kit positive cells was significantly lower in the refluxing megaureter (mean 83.60 ± 48.84 cells) than in the obstructive megaureter (mean 463.6 ± 100.4 cells; P < .05). Conclusions: The differences in the histopathologic aspects can provide information on the possible pathophysiology of obstructive and refluxing megaureters. Ureteral peristalsis can be affected by the increased myocyte apoptosis in the obstructive megaureter and by the decreased number of interstitial cells of Cajal-like cells and smooth muscle content in refluxing megaureters. Additional research is warranted to elucidate the exact pathophysiology.
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U2 - 10.1016/j.urology.2009.02.062
DO - 10.1016/j.urology.2009.02.062
M3 - Article
C2 - 19476980
AN - SCOPUS:67651122914
VL - 74
SP - 318
EP - 323
JO - Urology
JF - Urology
SN - 0090-4295
IS - 2
ER -