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Revista de la Facultad de Medicina Humana

English Title

Comparative histopathological study of the phrenic nerve from corpses with chronic obstructive pulmonary disease and without this condition

Keywords

enfermedad pulmonar obstructiva crónica, nervio frénico, microscopía, autopsia.

English Keywords

chronic obstructive pulmonary disease, phrenic nerve, microscopy, autopsy.

Abstract

Introducción: Los cambios funcionales resultantes de la evolución de la enfermedad pulmonar obstructiva crónica (EPOC) son progresivos e irreversibles, lo que provoca un aumento del trabajo del diafragma debido a la hiperinflación. Los nervios frénicos promueven la inervación del diafragma y pueden verse comprometidos en la condición de EPOC. Objetivo: Comparar la morfología de los nervios frénicos de los cadáveres con y sin EPOC, mediante microscopía óptica. El Estudio: Estudio descriptivo en el que las muestras de los pulmones y los nervios frénicos bilateralmente de los cadáveres con y sin diagnóstico de EPOC. Las muestras de tejido fueron fijadas y procesaron por histología convencional para laminas histológicas teñidas con hematoxilina-eosina. Las muestras fueron compuestas por pacientes con EPOC (EPOC) y sin EPOC (CTR). Esta clasificación se realizó después del análisis histológico. Las láminas histológicas se analizaron mediante microscopía óptica por un patólogo, que fue un evaluador que no conocía datos del estudio. Resultados: De acuerdo con los criterios de inclusión del estudio, se incluyeron 31 cadáveres en el grupo de EPOC y 7 cadáveres en el grupo CTR. En el análisis de los nervios frénicos, 8 cadáveres, es decir, 25.8%, del grupo de EPOC tuvieron cambios histopatológicos: edema perineural (75%, n=6), atrofia nerviosa (12.5%, n=1) e infiltrado eosinofílico perineural (12.5%, n=1). Conclusiones: Los nervios frénicos de los cadáveres con EPOC tienen tendencia a alteraciones histopatológicas, siendo el edema perineural la principal modificación encontrada.

English Abstract

Introduction: Functional changes resulting from the evolution of chronic obstructive pulmonary disease (COPD) are progressive and irreversible, causing increased diaphragm work due to pulmonary hyperinflation and airway obstruction. Phrenic nerves have promoted innervation of the diaphragm and may have been compromised in COPD condition. Objective: To compare the morphology of the phrenic nerves of the cadavers with COPD and without COPD by optical microscopy. Materials and methods: An exploratory descriptive studio conducted on the Death Verification Service in Alagoas. Pulmonary and phrenic nerve biopsies will be bilaterally taken from the cadavers after a necropsy with the diagnosis of COPD. Tissue samples were fixed and processed by conventional histology for hematoxylin-eosin (HE) histological slides. Biopsies are divided into experimental groups, one composed by patients with COPD and the other with patients without COPD (control - CTR). This classification was realized after the histological analysis, when typical halls of COPD were found. Histological slides were analyzed by optical microscopy by a pathologist, who was able to assess the study. Results: According to the inclusion and exclusion criteria of the study, if it includes 38 cadavers in the initial evaluation, of which 31 are included in the COPD group and 7 in the CTR group. In the analysis of the phrenic nerves, 8 cadavers, 25.8%, of the COPD group had histopathological changes: perineural edema (75%, n=6), nervous atrophy (12.5%, n=1) and perineural eosinophilic infiltrate (12.5%, n=1). The CTR group does not present histopathological alterations of the phrenic nerves. Conclusions: Given the hallmarks of the biopsies performed on the phrenic nerves of the corpses with COPD, we can infer that there is a tendency for nerve alteration, with perineural edema, to be the major modification found.

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