gms | German Medical Science

130. Kongress der Deutschen Gesellschaft für Chirurgie

Deutsche Gesellschaft für Chirurgie

30.04. - 03.05.2013, München

Calretinin, an immunochemical stain to facilitate Hirschsprung's disease

Meeting Abstract

Suche in Medline nach

  • Karla Santos - Centro colorectal para ninos de Mexico y Latinoamerica, Cirugia peditrica, Puebla
  • Luis De la Torre - Centro colorectal para ninos de Mexico y Latinoamerica, Cirugia peditrica, Puebla

Deutsche Gesellschaft für Chirurgie. 130. Kongress der Deutschen Gesellschaft für Chirurgie. München, 30.04.-03.05.2013. Düsseldorf: German Medical Science GMS Publishing House; 2013. Doc13dgch451

doi: 10.3205/13dgch451, urn:nbn:de:0183-13dgch4510

Veröffentlicht: 26. April 2013

© 2013 Santos et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

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Introduction: The histological study of the rectal biopsy remains the gold standard for the diagnosis of Hirschsprung’s disease. To decrease errors histochemical and immunohistochemical stains are used to help identify ganglion cells or define nerve fibers.

Barshack reported in 2004 that calretinin is absent in colonic nerve fibers of patients with HD, while it is present in patients without the disease. The Centro Colorectal para Niños de México y Latinoamérica provides care to HD patients with previous diagnostic and technical errors. The objective of this review was to establish the usefulness of calretinin as an immunohistochemical technique.

Material and methods: A retrospective review was done of the biopsy materials of twelve patients admitted with the suspected diagnosis of HD. These materials were already processed with the H-E protocol , and were reported as HD in eight patients and normoganglionic in four. The paraffin blocks were subject to immunohistochemistry with S-100 protein and calretinin.

The biopsy materials, including H-E, S-100 and calretinin for all of them, were reviewed by three Pathologists in an independent and blind fashion.

Results: The review of the H-E materials in this study resulted in overdiagnosis of HD by two of the three pathologists. Regarding the use of S100 protein, it resulted in under-diagnosis ranging from three to seven cases. With the calretinin stain none of the pathologists reported under or over diagnosis.

Conclusion: Calretinin has the advantage of its expression in mature and immature cells, both in the nerve cell body and its prolongations. The calretinin-antibody proved to be an efficient immunohistochemical tool to facilitate the diagnosis of HD, emphasizing the following points: it does not demand experience in its interpretation; it identifies mature and immature nerve cells; it is enough to observe its positivity in the neuritis.