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Utility of Peripherin Versus MAP-2 and Calretinin in the Evaluation of Hirschsprung Disease
- Source :
- Applied Immunohistochemistry & Molecular Morphology. 24:627-632
- Publication Year :
- 2016
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2016.
-
Abstract
- Hirschsprung disease (HD) is a congenital malformation resulting from the lack of migration of ganglion cells in the colon. The absence of ganglion cells in rectal suction biopsies aids in diagnosis, but evaluation of these small biopsies can be difficult. In this study, we compare the microtubule-associated protein-2 (MAP-2), calretinin, and peripherin immunohistochemical stains in 237 selected biopsies performed to rule out HD. By H&E stain, a total of 78 biopsies had ganglion cells, whereas 83 biopsies had no ganglion cells, and an additional 76 biopsies were equivocal for ganglion cells. Of the 78 biopsies with ganglion cells, MAP-2 was positive in 73 (94%), calretinin in 76 (97%), and peripherin in 78 (100%). Of the 83 biopsies with no ganglion cells, calretinin and peripherin highlighted nerve fibrils and ganglion cells, respectively, in 3 biopsies, whereas MAP-2 was positive in only 1 biopsy. Of the 76 biopsies equivocal for ganglion cells, 16 cases were positive by all 3 stains, an additional case by both calretinin and peripherin, and 2 cases by peripherin only. All of the newly positive biopsies were from patients without HD. This study demonstrates that peripherin is superior in helping to rule out HD in these small biopsies, highlighting ganglion cells in virtually all cases with ganglion cells, whereas MAP-2 and calretinin are less sensitive for identification of ganglion cells and nerve fibrils, respectively. In patients with HD, a panel using calretinin and peripherin with or without MAP-2 may be most helpful in identifying transition zones.
- Subjects :
- Pathology
medicine.medical_specialty
Histology
Adolescent
Biopsy
Peripherins
Disease
Stain
Pathology and Forensic Medicine
03 medical and health sciences
0302 clinical medicine
Humans
Medicine
In patient
Hirschsprung Disease
Child
medicine.diagnostic_test
business.industry
Infant, Newborn
Infant
Peripherin
Immunohistochemistry
Ganglion
Medical Laboratory Technology
medicine.anatomical_structure
nervous system
Calbindin 2
Child, Preschool
030220 oncology & carcinogenesis
030211 gastroenterology & hepatology
sense organs
Calretinin
business
Microtubule-Associated Proteins
Subjects
Details
- ISSN :
- 15412016
- Volume :
- 24
- Database :
- OpenAIRE
- Journal :
- Applied Immunohistochemistry & Molecular Morphology
- Accession number :
- edsair.doi.dedup.....78fd0d84f6c23b1352bd46754d39e715
- Full Text :
- https://doi.org/10.1097/pai.0000000000000241