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Original Article

Prevalence and Significance of Immature Ganglion Cell in Hirschsprung's Disease

Hee-Beom Yang, M.D.1, Hyun-Young Kim, M.D.1, Soo-Hong Kim, M.D.2, Sung-Eun Jung, M.D.1, Kwi-Won Park, M.D.1
Journal of the Korean Association of Pediatric Surgeons 2013;19(2):122-129.
Published online: December 24, 2013

1Department of Pediatric Surgery, Seoul National University Children's Hospital, Seoul, Korea.

2Department of Pediatric Surgery, Pusan National University Children's Hospital, Yangsan, Korea.

Correspondence: Hyun-Young Kim, M.D., Department of Pediatric Surgery, Seoul National University Children's Hospital, 101 Daehang-ro, Yeongeon-dong, Jongro-gu, Seoul 110-744, Korea. Tel: 02)2072-2478, Fax: 02)747-5134, spkhy02@snu.ac.kr
• Received: October 4, 2013   • Accepted: November 13, 2013

Copyright © 2013 Korean Association of Pediatric Surgeons

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  • Immature ganglion cell (IGC) is known for its relationship with intestinal motility and its impact on postoperative functional outcomes of Hirschsprung's disease (HD). There are few studies on the relationship between intestinal dysmotility and IGC in HD patients. 67 patients pathologically diagnosed with HD and who received definitive operation in Seoul National University Children's Hospital from 2010 to 2011 were included. 10 patients were excluded due to inadequate immunohistochemical staining results. The proximal end of resected ganglionic segment was evaluated with immunohistochemistry examination with MAP-2, a marker of ganglionic cells and bcl-2, a marker of IGCs The median age at operation was 155 (15-4678) day-old. 55 (96.5%) patients positive for bcl-2, were regarded as having IGC, and 2 (3.5%) patients positive for MAP-2 but negative for bcl-2, were regarded as having only mature ganglion cells. In the bcl-2 positive group, there were 7 patients (12.7%) with constipation, 15 patients (27.3%) with soiling, 3 patients (5.5%) with perianal excoriation and 6 patients (10.9%) with medication use. In bcl-2 negative group, intestinal dysmotility was not seen. There was no statistical significance in the two groups. Considering that HD is diagnosed at a young age, the rate of IGC present is very high and it might be inappropriate to relate IGC to functional outcome at young ages.
  • Keywords: Hirschsprung's disease; Immature ganglion cell; Prevalence; bcl-2
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Fig. 1
H&E and Immunohistochemical Staining of Ganglion Cell. A: Ganglion Cell in H&E, B: Mature Ganglion Cell in MAP-2, C: Immature Ganglion Cell in bcl-2
jkaps-19-122-g001.jpg
Table 1
Comparisons according to Immunohistochemistry
jkaps-19-122-i001.jpg

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Prevalence and Significance of Immature Ganglion Cell in Hirschsprung's Disease
J Korean Assoc Pediatr Surg. 2013;19(2):122-129.   Published online December 24, 2013
DOI: https://doi.org/10.13029/jkaps.2013.19.2.122
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Prevalence and Significance of Immature Ganglion Cell in Hirschsprung's Disease
J Korean Assoc Pediatr Surg. 2013;19(2):122-129.   Published online December 24, 2013
DOI: https://doi.org/10.13029/jkaps.2013.19.2.122
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Prevalence and Significance of Immature Ganglion Cell in Hirschsprung's Disease
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Fig. 1 H&E and Immunohistochemical Staining of Ganglion Cell. A: Ganglion Cell in H&E, B: Mature Ganglion Cell in MAP-2, C: Immature Ganglion Cell in bcl-2

Fig. 1

Prevalence and Significance of Immature Ganglion Cell in Hirschsprung's Disease

Comparisons according to Immunohistochemistry

Table 1 Comparisons according to Immunohistochemistry

Table 1

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