Diagnostic significance of calretinin in Hirschsprung’s Disease
DOI:
https://doi.org/10.59736/IJP.24.01.1053Keywords:
Calretinin, H&E staining, Hirschsprung’s disease, Immunohistochemistry.Abstract
Background: Rectal biopsy is considered to be the gold standard for diagnosing Hirschsprung’s disease (HD). At our center, both hematoxylin and eosin (H&E) staining and Calretinin immunohistochemistry are routinely employed to enhance diagnostic accuracy. This study aimed to evaluate the diagnostic significance of Calretinin staining compared to traditional H&E staining in children with suspected HD.
Methods: A cross-sectional study was conducted at the Department of Pediatric Surgery, from October, 2021, to May, 2023. A total of 166 patients with clinical and radiological suspicion of HD underwent rectal or colonic biopsies. Patients were categorized into five histological groups based on H&E findings. Data were analyzed using SPSS v22, with sensitivity, specificity, and predictive values calculated using 2×2 contingency tables. Statistical significance was set at p ≤ 0.05.
Results: Among the 213 patients analyzed for Calretinin staining, 165 cases (77.4%) as HD (Calretinin-negative) were identified and excluded HD in 48 cases (22.6%). out of 166, 128 (77.1%) were males and 38 (22.9%) females. Age distribution showed that 93 patients (56%) were between 0–7 years, while 73 patients (44%) were between 8–14 years. In comparison, H&E staining diagnosed 160 cases (75.1%) as HD. Calretinin demonstrated a sensitivity of 100%, specificity of 100%, positive predictive value (PPV) of 100%, negative predictive value (NPV) of 100%, and overall diagnostic accuracy of 100%. Notably, in histologically ambiguous cases (Group C), Calretinin staining helped reclassify 5 of 12 biopsies as a ganglionic, significantly impacting diagnosis and treatment planning.
Conclusion: Calretinin immunohistochemistry is a reliable and valuable adjunct in the diagnosis of Hirschsprung’s disease. With high sensitivity, specificity, and diagnostic accuracy, Calretinin proves particularly useful in ambiguous cases and should be considered a standard part of histopathological evaluation for HD.
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