title: Calretinin immunohistochemistry: a simple and efficient tool to diagnose Hirschsprung disease.
abstract: Diagnosis of Hirschsprung disease (HD) is quite entirely based on the histopathological analysis of suction rectal biopsies. This hematoxylin and eosin approach has some limitations, despite the help of acetylcholinesterase staining. The aim of this study was to assess the diagnostic value of calretinin immunochemistry as a simple and reliable method in the diagnosis of HD. A total of 131 initial rectal biopsies carried out for suspicion of HD in children were retrieved, and calretinin immunohistochemistry was carried out on paraffin-embedded biopsies. Diagnosis of HD was made when no staining was observed. The results were statistically analyzed in comparison with our standard method (histology and acetylcholinesterase staining). 130 biopsies were accurately diagnosed on the basis of the positivity or negativity of calretinin staining. The senior pathologists diagnosed all cases of HD with no false positives. Furthermore, 12 additional cases initially considered as doubtful for HD using the standard method, were accurately diagnosed using calretinin immunohistochemistry. The false negative was a case of HD with a calretinin-positive biopsy. We also demonstrate the ease of calretinin interpretation compared with acetylcholinesterase for the junior pathologist. Calretinin immunohistochemistry overcomes most of the difficulties encountered using the combination of histology and acetylcholinesterase staining, and detects almost all cases of HD with confidence, with no false positives. Thus, we demonstrate that calretinin is superior to acetylcholinesterase to complete histology and could advantageously substitute for acetylcholinesterase.
authors: Service de pathologie, hôpital Robert Debré, APHP et Université Paris, 48 boulevard Sérurier, Paris, France.
authors: Vincent
authors: V
authors: Guinard-Samuel
authors: Arnaud
authors: A
authors: Bonnard
authors: Pascal
authors: P
authors: De Lagausie
authors: Pascale
authors: P
authors: Philippe-Chomette
authors: Corine
authors: C
authors: Alberti
authors: Alaa
authors: A
authors: El Ghoneimi
authors: Michel
authors: M
authors: Peuchmaur
authors: Dominique
authors: D
authors: Berrebi-Binczak
mesh_terms: D000110:Acetylcholinesterase / Q000032:analysis; D015415:Biomarkers / Q000032:analysis; D001706:Biopsy; D064032:Calbindin 2; D002648:Child; D002675:Child, Preschool; D002983:Clinical Competence; D004396:Coloring Agents / Q000627:therapeutic use; D004801:Eosine Yellowish-(YS); D005188:False Negative Reactions; D005260:Female; D006416:Hematoxylin; D006627:Hirschsprung Disease / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology; D006801:Humans; D007150:Immunohistochemistry; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011237:Predictive Value of Tests; D012007:Rectum / Q000737:chemistry* / Q000201:enzymology / Q000473:pathology; D015203:Reproducibility of Results; D012189:Retrospective Studies; D064030:S100 Calcium Binding Protein G / Q000032:analysis*
chemical_list: D015415:Biomarkers; C576764:CALB2 protein, human; D064032:Calbindin 2; D004396:Coloring Agents; D064030:S100 Calcium Binding Protein G; D000110:Acetylcholinesterase; D004801:Eosine Yellowish-(YS); D006416:Hematoxylin