Spectrum of Interstitial Cell of Cajal Deficits in Chronic Gastroduodenal Disorders: Systematic Review and Meta-Analysis.

Abnormalities of interstitial cells of Cajal (ICC), a subset of which generate pacemaker signals and subsequently motility, have been implicated in their pathophysiology.

间质细胞（ICC）的异常，其中一部分产生起搏信号并随后产生运动，已被认为是其病理生理学的一部分。

We systematically reviewed the literature to pool ICC deficits observed in chronic neurogastroduodenal disorders.

我们系统地回顾了文献，以汇总在慢性神经胃肠十二指肠疾病中观察到的间质细胞球蛋白（ICC）缺陷。

Methods

Studies quantifying gastric ICC from the corpus or antrum, in adult patients with gastroparesis, functional dyspepsia (FD), or chronic nausea and vomiting syndromes (CNVS) were analyzed (PROSPERO: CRD42024613226).

分析了定量胃体或胃窦中胃间质细胞球蛋白（ICC）的成人患者研究，这些患者患有胃轻瘫、功能性消化不良（FD）或慢性恶心和呕吐综合症（CNVS）（PROSPERO: CRD42024613226）。

MEDLINE, Embase and CENTRAL databases were searched systematically.

系统性地检索了MEDLINE、Embase和CENTRAL数据库。

Random effects meta-analyses were used to compare ICC counts by disorder group with subgroup analysis by quantification methodology.

使用随机效应的荟萃分析比较了不同疾病组的ICC计数，并根据定量方法进行了亚组分析。

Results

Overall, 2,158 studies were screened and 22 included.

总共筛查了2,158项研究，最终纳入了22项。

Comparative studies (n = 12) showed patients with chronic neurogastroduodenal disorders (n = 167 with gastroparesis, n = 19 with FD ± CNVS) had lower ICC counts than nondiabetic controls (n = 130); standardized mean difference -1.58, 95% confidence interval-2.09 to -1.07, P < 0.0001, with more severe deficits in gastroparesis compared to FD ± CNVS (standardized mean difference [SMD] -0.44, P = 0.048).

比较研究(n = 12)显示，患有慢性神经胃肠十二指肠疾病的患者(n = 167患有胃轻瘫，n = 19患有FD ± CNVS)的ICC计数低于非糖尿病对照组(n = 130)；标准化平均差异为-1.58，95%置信区间为-2.09至-1.07，P < 0.0001，胃轻瘫患者的缺陷比FD ± CNVS更为严重(标准化平均差异[SMD]为-0.44，P = 0.048)。

A spectrum of ICC deficits was evident in a subgroup of studies using gold-standard methods with c-KIT antibody and 4',6-diamidino-2-phenylindole-stained nuclei confirmation (7 studies, 246 patients: mean ICC counts 2.29 in gastroparesis vs 3.49 in FD ± CNVS, and 5.27 in controls; P < 0.001 all comparisons).

在使用金标准方法（c-KIT抗体和4',6-二氨基-2-苯基吲哚染色核确认）的一组研究中，ICC缺陷的范围显而易见（7项研究，246名患者：胃轻瘫患者的平均ICC计数为2.29，功能性消化不良伴有或不伴有慢性恶心和呕吐综合征患者的平均ICC计数为3.49，对照组为5.27；所有比较的P值均<0.001）。

Most studies were at high risk of bias (n = 21).

大多数研究存在高风险偏倚（n = 21）。

Discussion

Marked depletion of ICC is a consistent finding in neurogastroduodenal disorders.

ICC的显著耗竭是在神经胃肠十二指肠疾病中一致发现的结果。

A spectrum of disease is revealed, with greater depletion associated with delayed emptying.

揭示了一系列疾病，耗竭程度更大的与排空延迟有关。

Techniques for clinically defining ICC-driven gastric neuromuscular dysfunction should be prioritized.

应优先考虑用于临床定义由ICC驱动的胃神经肌肉功能障碍的技术。