DOI: http://dx.doi.org/10.18203/2349-2902.isj20190810

Comparative study between use of calretinin and synaptophysin immunostaining in diagnosis of Hirschsprung disease

Mahmoud Sheir, Rehab M. Samaka, Tamer Fakhry, Ayman A. Albatanony

Abstract


Background: Hirschsprung disease (HD) is diagnosed by absence of ganglion cells in rectal biopsy. In some cases, standard methods fail to diagnose agangliosis. The aim of this study is to assess the diagnostic value of immunohistochemistry (IHC) of calretinin and synaptophysin compared to standard methods.

Methods: This prospective cross section study was conducted in Menoufia University hospitals, Egypt spanning the period between October 2017 to December 2018. Rectal biopsies of the clinically suspected HD patients stained with calretinin and synaptophysin and their results compared to the standard hematoxylin and eosin (H&E) stained sections.

Results: A total of 30 patients aged from 3 days to 2 years with a male to female ratio 11:4 were examined for rectal biopsies. Sections of 9 cases were diagnosed HD. In inadequate specimens, sensitivity and specificity of calretinin and synpatophysin (100%, 80%) and (100%, 85.71%) respectively were superior to the sensitivity (40%) and specificity (14%) of H&E. However, in adequate specimens, results of H&E, calretinin and synaptophysin were the same.

Conclusions: Immunohistochemical expression of calretinin and synaptophysin were conclusive, diagnostic and superior to the results of H&E stained section in inadequate. However, in adequate specimens calretinin and synaptophysin were consistent and confirmatory to the results of H&E sections.

Keywords


Calretenin, Hirschsprung disease, Immunohistochemistry

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References


Zuikova V, Franckevica I, Strumfa I, Melderis I. Immunohistochemical Diagnosis of Hirschsprung ’ s Disease and Allied Disorders. Acta Chir Latv. 2015;15(1):50-7.

Nouira F, Ben Ahmed Y, Sarrai N, Ghorbel S, Jlidi S, Khemakhem R, et al. Surgical Management of Recto-Sigmoid Hirschsprung’s Disease. Acta Chir Belg. 2012;112(2):126-30.

Fukuzawa M. Progress in the treatment of and research on Hirschsprung’s disease. Nihon Geka Gakkai Zassh. 2014;115(6):312-6.

Kapur RP. Calretinin-Immunoreactive Mucosal Innervation in Very Short-Segment Hirschsprung Disease : A Potentially Misleading Observation. Pediatr Dev Pathol. 2014;17(1):28-35.

Jiang M, Li K, Li S, Yang L, Yang D, Zhang X, et al. Calretinin, S100 and protein gene product 9.5 immunostaining of rectal suction biopsies in the diagnosis of Hirschsprung’ disease. Am J Transl Res. 2016;8(7):3159-68.

Yadav L, Babu MK, Das K, Mohanty S, Divya P, Shankar G, et al. Role of synaptophysin in the intraoperative assessment of quadrantic innervation of the proximal doughnut in Hirschsprung disease. Natl Med J India. 2017;30(4):187-92.

Mukhopadhyay B, Sengupta M, Das C, Mukhopadhyay M, Barman S, Mukhopadhyay B. Immunohistochemistry-based comparative study in detection of Hirschsprung’s disease in infants in a Tertiary Care Center. J Lab Physicians. 2017;9(2):76.

Hiradfar M, Sharifi N, Khajedaluee M, Zabolinejad N, Jamshidi ST. Calretinin Immunohistochemistery : An Aid in the Diagnosis of Hirschsprung ’ s Disease. Iran J Basic Med Sci. 2012;15(5):1053-9.

Muise ED, Cowles RA. Rectal biopsy for Hirschsprung’s disease: a review of techniques, pathology, and complications. World J Pediatr. 2016;12(2):135-41.

Tran VQ, Lam KT, Truong DQ, Dang MH, Doan TTP, Segers V, et al. Diagnostic value of rectal suction biopsies using calretinin immunohistochemical staining in Hirschsprung ’ s disease. J Pediatr Surg. 2016;51(12):2005-9.

Kapur RP, Reed RC, Finn LS, Patterson K, Johanson J, Rutledge JC. Calretinin Immunohistochemistry versus Acetylcholinesterase Histochemistry in the Evaluation of Suction Rectal Biopsies for Hirschsprung Disease. Pediatr Dev Pathol. 2009;12(1):6-15.

Guinard-Samuel V, Bonnard A, De Lagausie P, Philippe-Chomette P, Alberti C, El Ghoneimi A, et al. Calretinin immunohistochemistry: a simple and efficient tool to diagnose Hirschsprung disease. Modern Pathol. 2009 Oct;22(10):1379.

Bjørn N, Rasmussen L, Qvist N, Detlefsen S, Ellebæk MB. Full-thickness rectal biopsy in children suspicious for Hirschsprung’s disease is safe and yields a low number of insufficient biopsies. J Pediatr Surg. 2018;53(10):1942-4.

Kobayashi H, Miyano T, Yamataka A, Lane GJ, Fujimoto T, Puri P. Use of Synaptophysin Polyclonal Antibody for the Rapid Intraoperative Immunohistochemical Evaluation of Functional Bowel Disorders. J Pediatr Surg. 1997;32(1):38-40.

Lourenção PLTA, Valerini FG, Cataneo AJM, Ortolan EVP, Silveira GLD, Piva MFL, et al. Barium Enema Revisited in the Workup for the Diagnosis of Hirschsprungʼs Disease. J Pediatr Gastroenterol Nutr. 2019:1.

Yadav L, Kini U, Das K, Mohanty S, Puttegowda D. Calretinin immunohistochemistry versus improvised rapid Acetylcholinesterase histochemistry in the evaluation of colorectal biopsies for Hirschsprung disease. Indian J Pathol Microbiol. 2014;57(3):369.

Rakhshani N, Araste M, Imanzade F, Panahi M, Tameshkel FS, Sohrabi MR, et al. Hirschsprung Disease Diagnosis: Calretinin Marker Role in Determining the Presence or Absence of Ganglion Cells. Iran J Pathol. 2016;11(4):409-15.

Musa ZA, Qasim BJ, Ghazi HF, Al Shaikhly AWA. Diagnostic roles of calretinin in hirschsprung disease: A comparison to neuron-specific enolase. Saudi J Gastroenterol. 2017;23(1):60.

Gonzalo D. H, Plesec T. Hirschsprung Disease and Use of Calretinin in Inadequate Rectal Suction Biopsies. Arch Pathol Lab Med. 2013;137(8):1099-102.

Borrego S, Ruiz-Ferrer M, Fernández RM, Antiñolo G. Hirschsprung’s disease as a model of complex genetic etiology. Histol Histopathol. 2013;28(9):1117-36.