The expression of Cajal cells at the obstruction site of congenital pelviureteric junction obstruction and quantitative image analysis

Abstract

Objective The study aimed to analyze the expression and significance of interstitial cells of Cajal (ICC) at the obstruction site of congenital pelviureteric junction obstruction (PUJO). Methods Specimens of the strictured segment of the PUJ were obtained from 24 patients who were diagnosed to have PUJO (without aberrant vessels and adhesive band compression of ureteral junction) intraoperatively. In the control group, PUJ specimens were taken from 21 patients who had Wilms' tumor. Pelviureteric junction tissues were confirmed to be free of tumor invasion by histology. Immunohistochemistry with c-kit antibody was performed to detect the expression of ICC in specimens of the 2 groups. Quantitative analysis was made using image analysis technique and statistical analysis was carried out. Results Immunoreactivity to ICC was predominantly detected in the muscle layers of PUJ. The mean area of ICC expression in the PUJO group was 14.86 ± 1.37 × 10 4 μm 2 , which was lower than that in the control group (16.80 ± 1.68) × 10 4 μm 2 ( P < .01). The mean density of ICC expression in the PUJO was 0.207 ± 0.020, which was also lower than that in the control group (0.262 ± 0.026) ( P < .05). Conclusions A reduction of the number of ICC may play an important role in the etiology and pathogenesis of PUJO.