抄録
The etiology of idiopathic carpal tunnel syndrome remains poorly understood. This study investigated the relationship between idiopathic carpal tunnel syndrome and transverse carpal tunnel ligament histology, especially clinical severity of this disease and immunohistochemistry of the ligament. Ligament biopsy specimens were obtained from eleven wrists during operation for carpal tunnel release, and one control specimen was obtained. After staining of different slices from each specimen with HE and antibodies to collagen types I to VI, each slice was classified into 3 grades based on pathology, where grade 1 was the least and 3 the greatest pathological progression. Out of eight specimens from mild carpal tunnel syndrome patients, 4 were grade H-1, and the other 4 were grade H-2 based on HE staining. Out of 4 specimens from moderate to severe carpal tunnel syndrome patients, 1 was grade H-2 and the other 3 were grade H-3 with HE. Grades for anti-type I collagen were C-1 in 6 out of 8 mild CTS patients, whereas the grades were C-2 or C-3 in 3 out of 4 moderate to severe patients. Grades for anti-type III collagen were C-1 in 4 out of 4 mild patients whereas the grades were C-2 or C-3 in all 4 moderate to severe. The sum of type I and type III grades were 2 in control patients, 2-3 in the mild CTS patients, 4 in the moderate patients and 6 in the severe patients.
There was a correlation between the severity of this disease and the degree of transverse ligament pathology stained with HE, anti-type I and III collagen antibodies. These suggest that disturbance of the maturation of collagen fibers in the transverse carpal ligament is an important factor in idiopathic carpal tunnel syndrome.
