钙视网膜蛋白免疫组织化学染色直肠吸引活检在先天性巨结肠症中的诊断价值
Diagnostic value of rectal suction biopsies using calretinin immunohistochemical staining in Hirschsprung's disease.
作者信息
Tran Viet Quoc, Lam Kim Thien, Truong Dinh Quang, Dang Minh Hoang, Doan Thao Thi Phuong, Segers Valerie, Butler Marilyn West, Robert Annie, Goyens Philippe, Steyaert Henri
机构信息
Department of Pediatric Surgery, Children's Hospital 2, Ho Chi Minh City, Vietnam; Department of Pediatric Surgery, Queen Fabiola Children's University Hospital, Université Libre de Bruxelles (ULB), Brussels, Belgium.
Department of Pediatric Surgery, Children's Hospital 2, Ho Chi Minh City, Vietnam.
出版信息
J Pediatr Surg. 2016 Dec;51(12):2005-2009. doi: 10.1016/j.jpedsurg.2016.09.027. Epub 2016 Sep 15.
BACKGROUND
The study investigates the diagnostic value of calretinin immunohistochemical staining (CIS) on rectal suction biopsies (RSB) in Hirschsprung's disease (HD).
METHODS
A prospective study was conducted at Children's Hospital 2 in Ho Chi Minh City, Vietnam, from January through December 2015. Patients suspected of HD during this period underwent RSB and were followed in order to assess the accuracy of the diagnostic test with CIS compared with conventional histology (H&E).
RESULTS
A total of 188 children with RSB were investigated. Median age was 7.1 (range 0.2-159) months with 65.4% boys. HD was confirmed in 80 (42.6%) children. There were 1 false positive and no false-negative cases. The sensitivity and specificity were 100% (80/80) and 99.1% (107/108) for CIS and 100% and 85.2% for H&E, respectively. Cohen's kappa coefficient was 0.9891 with a diagnostic accuracy of 99.5% for CIS, compared with 0.8303 and 91.5% for H&E, respectively. There were no serious complications related to the RSB.
CONCLUSION
RSB with CIS is a useful diagnostic method for HD, with easy interpretation and no need for cryostat. CIS has a high diagnostic accuracy and should be considered as the primary method for the diagnosis of HD by RSB.
LEVEL OF EVIDENCE
Diagnostic Studies - Level I.
背景
本研究探讨钙视网膜蛋白免疫组织化学染色（CIS）在先天性巨结肠（HD）直肠吸引活检（RSB）中的诊断价值。
方法
2015年1月至12月在越南胡志明市第二儿童医院进行了一项前瞻性研究。在此期间疑似患有HD的患者接受了RSB检查，并进行随访，以评估与传统组织学（苏木精-伊红染色，H&E）相比CIS诊断试验的准确性。
结果
共对188例接受RSB检查的儿童进行了研究。中位年龄为7.1（范围0.2 - 159）个月，男孩占65.4%。80例（42.6%）儿童确诊为HD。有1例假阳性病例，无假阴性病例。CIS的敏感性和特异性分别为100%（80/80）和99.1%（107/108），H&E的敏感性和特异性分别为100%和85.2%。CIS的Cohen's kappa系数为0.9891，诊断准确率为99.5%，而H&E的Cohen's kappa系数为0.8303，诊断准确率为91.5%。未出现与RSB相关的严重并发症。
结论
RSB联合CIS是HD的一种有用诊断方法，易于解读且无需使用低温恒温器。CIS具有较高的诊断准确率，应被视为RSB诊断HD的主要方法。
证据水平
诊断性研究 - I级。
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