Torre L, Santos K

Language: English
References: 13
Page: 246-251
PDF size: 619.41 Kb.

ABSTRACT

Introduction. Rectal biopsy and its histopathologic study with hematoxylin and eosin (HE) is the gold standard for Hirschsprung disease (HD) diagnosis. However, this procedure is a common challenge and wrong diagnoses arise when an inadequate rectal biopsy or inaccurate histological process and/or examination are made. Recently, to increase the diagnostic accuracy of HD, an ancillary immunohistochemistry (IHQ) test with calretinin has been used. The aim of this study was to establish the concordance, sensibility and specificity of calretinin in our laboratory to diagnose aganglionosis.
Methods. Twelve rectal biopsies of patients admitted because suspected HD were included. The histologic study was done observing fifty sections stained with HE and diagnoses were: eight HD (aganglionic) and four idiopathic constipated (normoganglionic) patients. These biopsies were re-evaluated blindly and independently by three pathologists. S-100 and calretinin IHQ stains were added for this study. The analysis of the results was performed with the SPSS 19.0. The concordance was established with kappa test.
Results. The global kappa showed that calretinin had a perfect concordance and was statistically significant (p=‹0.0001) being better than HE (p=0.01) and PS100 (p=0.12).
Conclusion. HE is the stain that should be used in the study of rectal biopsies to observe ganglion cells. Calretinin is a good ancillary method that can be used for pathologists, it showed great sensibility and specificity and a perfect concordance between observers.

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