title: Quantitative assessment of CD30+ lymphocytes and eosinophils for the histopathological differential diagnosis of inflammatory bowel disease.
abstract: OBJECTIVE
  The histopathological discrimination of Crohn's disease [CD] and ulcerative colitis [UC] can be challenging. The aim of this study was to evaluate if quantification of CD30(+) lymphocytes and eosinophils in histopathological material improves the accuracy of diagnosis of inflammatory bowel disease.
  
  
  METHODS
  A total of 156 patients were diagnosed with IBD by a gastroenterologist and corroborated by 5 years of follow-up. Patients were treatment naïve at the time of biopsy. Samples were taken from diseased areas of the colon and examined by a gastrointestinal pathologist.
  
  
  RESULTS
  The median number of eosinophils in biopsies from affected segments was 42/high power field [hpf] [25.5-63.5] in CD and 98/hpf [67-123] in UC [p < 0.001]. Biopsies containing ≥ 70 eosinophils/hpf field had a sensitivity of 78.3% and a specificity of 71% for the diagnosis of UC ({area under the receiver operating characteristic (ROC) curve 0.767 (95% confidence interval [CI] 0.696-0.838)}. There was a median of three CD30(+) cells/hpf [range 2-6] in diseased CD biopsies and 33 cells/hpf [24-52] in diseased UC biopsies [p < 0.001]. The cut-off determined by the ROC curve was 15 (sensitivity 97.4%, specificity 97.4%, positive likelihood ratio (PLR) 17.1, Negative likelihood ratio (NLR) 0.03, area under the curve [AUC]: 0.978; 95% CI 0.95310.999).
  
  
  CONCLUSIONS
  Routine histopathological assessment with quantification of CD30+ cells is highly accurate at discriminating CD and UC. All the measured parameters are easy to perform, low-cost, and available in most pathological laboratories.
authors.affiliation: Gastroenterology and Hepatology Sciences, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brasil cfloresgastro@gmail.com.
authors.forename: Cristina
authors.initials: C
authors.lastname: Flores
authors.affiliation: Gastroenterology and Hepatology Sciences, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brasil.
authors.forename: Carlos Fernando
authors.initials: CF
authors.lastname: Francesconi
authors.affiliation: Gastroenterology and Hepatology Sciences, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brasil.
authors.forename: Luíse
authors.initials: L
authors.lastname: Meurer
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000378:metabolism; D001706:Biopsy; D003093:Colitis, Ulcerative / Q000276:immunology / Q000473:pathology*; D003106:Colon / Q000276:immunology / Q000473:pathology*; D003424:Crohn Disease / Q000276:immunology / Q000473:pathology*; D003937:Diagnosis, Differential; D004804:Eosinophils / Q000378:metabolism*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D017730:Ki-1 Antigen / Q000378:metabolism*; D007958:Leukocyte Count; D008214:Lymphocytes / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D055815:Young Adult
chemical_list: D015415:Biomarkers; D017730:Ki-1 Antigen
keywords: Inflammatory bowel disease; eosinophils; immunohistochemistry