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Abstract

BACKGROUND: 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. OBJECTIVE: 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.  RESULTS: 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%. CONCLUSION: Immunohistochemistry Calretinin can be used for the diagnosis of HD as a dependable and ancillary method.  

DOI

10.52573/ipmj.2020.167328

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