Mukhopadhyay Biswanath, Mukhopadhyay Madhumita, Mondal Kartic Chandra, Sengupta Moumita, Paul Antara
Pediatric Surgeon, Department of Paediatric Surgery, Apollo Gleanagles Hospital , Kolkata, India .
Professor, Department of Pathology, Institute of Post Graduate Medical Education and Research , Kolkata, India .
J Clin Diagn Res. 2015 Jul;9(7):EC06-9. doi: 10.7860/JCDR/2015/12470.6180. Epub 2015 Jul 1.
Hirschsprung's disease is a classic example of a complex genetic disease, characterized by the lack of enteric ganglia in the submucosal and myenteric plexuses, along variable portions of the distal gut. The diagnosis of Hirschsprung's disease is based on a combination of clinical features, radiological appearance of the bowel and histological features in Haematoxylin & Eosin stained sections of intestinal biopsies. Calretinin Immunohistochemistry is emerging to be one of the newer methods.
This study was undertaken to ascertain 1) clinical profile; 2) mode of presentation; 3) to evaluate the role of Calretinin immunostain in the diagnosis of Hirschsprung's Disease.
This prospective and observational study was conducted in the Department of Pathology IPGME&R from July 2013 to September 2014. Eighty nine patients, clinically and radiologically diagnosed with Hirschsprung's disease underwent surgery and were included in the study. The data of every patient including age, sex and presenting symptoms were recorded. Eventually, histopathological examination & immunohistochemistry were done.
Total number of cases studied was 89 which aged between 0 days to 28 days. Overall sensitivity in our study to diagnose presence or absence of ganglion cells by calretinin immunohistochemistry was 100% and the specificity is 97.44% with positive and negative predictive value of 84.62 % and 100 % respectively.
Calretinin immunohistochemistry holds several advantages, and it's simple and not doubtful; and it is either positive or negative.
先天性巨结肠症是复杂遗传疾病的典型例子,其特征是远端肠道不同部位的黏膜下和肌间神经丛中缺乏肠神经节。先天性巨结肠症的诊断基于临床特征、肠道放射学表现以及苏木精和伊红染色的肠道活检切片的组织学特征。钙视网膜蛋白免疫组织化学正逐渐成为一种新方法。
本研究旨在确定1)临床特征;2)表现方式;3)评估钙视网膜蛋白免疫染色在先天性巨结肠症诊断中的作用。
这项前瞻性观察性研究于2013年7月至2014年9月在IPGME&R病理科进行。89例临床和放射学诊断为先天性巨结肠症的患者接受了手术并纳入研究。记录每位患者的年龄、性别和症状等数据。最后进行了组织病理学检查和免疫组织化学检查。
研究的病例总数为89例,年龄在0天至28天之间。在我们的研究中,通过钙视网膜蛋白免疫组织化学诊断神经节细胞有无的总体敏感性为100%,特异性为97.44%,阳性预测值和阴性预测值分别为84.62%和100%。
钙视网膜蛋白免疫组织化学有几个优点,它简单且无疑问,结果非正即负。