title: Expression of E-selectin and vascular cell adhesion molecule-1 in so-called 'negative' appendices: first results to support the pathological diagnosis in borderline cases.
abstract: BACKGROUND
  Since the rate of histologically 'negative' appendices still ranges between 15 and 20%, appendicitis in 'borderline' cases remains a challenging disease. As previously described, cell adhesion molecule expression correlates with different stages of appendicitis. Therefore, it was of interest to determine whether the 'negative' appendix correlated with the absence of E-selectin or vascular cell adhesion molecule-1 (VCAM-1).
  
  
  METHODS
  Nineteen grossly normal appendices from a series of 120 appendectomy specimens from patients with suspected appendicitis were analysed in frozen sections for the expression of E-selectin and VCAM-1. As control, 5 normal appendices were stained.
  
  
  RESULTS
  This study showed a coexpression of E-selectin and VCAM-1 in endothelial cells in early and recurrent appendicitis. In patients with symptoms for less than 6 h, only E-selectin was detected. Cases with fibrosis and luminal obliteration were only positive for VCAM-1. In cases of early appendicitis with symptoms of less than 6 h duration, a discordance between histological and immunohistochemical results was found.
  
  
  CONCLUSIONS
  This report indicates that E-selectin and VCAM-1 expression could be useful parameters in the diagnosis of appendicitis in borderline cases.
authors.affiliation: Institute of Pathology, University Medical Centre Mainz, Mainz, Germany. brochhausen @ pathologie.klinik.uni-mainz.de
authors.forename: C
authors.initials: C
authors.lastname: Brochhausen
authors.forename: F
authors.initials: F
authors.lastname: Bittinger
authors.forename: V H
authors.initials: VH
authors.lastname: Schmitt
authors.forename: F
authors.initials: F
authors.lastname: Kommoss
authors.forename: H-A
authors.initials: HA
authors.lastname: Lehr
authors.forename: A
authors.initials: A
authors.lastname: Heintz
authors.forename: C J
authors.initials: CJ
authors.lastname: Kirkpatrick
mesh_terms: D001062:Appendectomy; D001064:Appendicitis / Q000175:diagnosis* / Q000378:metabolism* / Q000473:pathology / Q000601:surgery; D001065:Appendix / Q000378:metabolism / Q000473:pathology; D016022:Case-Control Studies; D019040:E-Selectin / Q000378:metabolism*; D042783:Endothelial Cells / Q000378:metabolism / Q000473:pathology; D005629:Frozen Sections; D007150:Immunohistochemistry; D010865:Pilot Projects; D012008:Recurrence; D012189:Retrospective Studies; D013997:Time Factors; D019010:Vascular Cell Adhesion Molecule-1 / Q000378:metabolism*
chemical_list: D019040:E-Selectin; C546936:SELE protein, human; D019010:Vascular Cell Adhesion Molecule-1