The Utility of Calretinin Immunohistochemistry in the Diagnosis of Hirschsprung’s Disease
Iraqi Postgraduate Medical Journal,
2020, Volume 19, Issue 4, Pages 338-344
Hirschsprung’s disease (HD) is a congenital intestinal motility disorder with absence of ganglion cells in the colonic wall, Diagnosis of the disease is based primarily on histopathological analysis, but in this respect, there are limitations associated with standard histology and histochemistry. Calretinin immunohistochemistry (IHC) was implemented to solve the diagnostic problems of this disease as a diagnostic marker.
We aimed to test, identify and compare the immunostaining calretinin in the aganglionic segment of colon specimens and to assess the diagnostic importance of the process with the normoganglionic segment (control group).
PATIENTS AND METHODS:
The specimens contained 40 patients with HD histopathology and 20 others (as a control group) who were colectomied for other reasons,60 paraffin wax blocks were analyzed for full-blown bowel specimens and rectum biopsy. Sixty) paraffin wax) blocksof full bowel thickness and rectal biopsy were examined. In IHC stained slides, calretinine immunoreactivity and pattern of stain for ganglion cells( nuclear and cytoplasmic)and nerve fibers in different bowel layers were assessed.
Calreinin Immunostaining was positive of ganglion cells(nuclear and cytoplasmic staining) and nerve fibers in the mucosa) lamina propria(, submucosa and muscularis propria in all specimens of control group except one case (2.5 percent), calretinin immunoexpression of ganglion cells and nerve fibers was negatively(-) ,In aganglionic segments (case group).This method had sensitivity of 97.5% and specificity of 100% for diagnosis of HD. The positive predictive value was 100% and negative predictive value was 95.2%.
Immunohistochemistry Calretinin can be used for the diagnosis of HD as a dependable and ancillary method.
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