A new systematization of histological analysis for the diagnosis of Hirschsprung's disease

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art_SERAFINI_A_new_systematization_of_histological_analysis_for_the_2023.PDF (1.22 MB)
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0
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article
Data de publicação
2023
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Scopus
Web of Science
PubMed
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ELSEVIER ESPANA
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CLINICS, v.78, article ID 100198, 6p, 2023
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Unidades Organizacionais
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Resumo
Background: Hirschsprung's Disease (HD) is characterized by intestinal sub-occlusion and the absence of enteric ganglion cells. A rectal biopsy examination is performed to confirm the diagnosis. In a recent study, we demon-strated that the analysis of 60 sections of rectal mucosa and submucosa stained by H&E may ensure a 90% diag-nostic accuracy. Although the need to analyze so many sections makes the process of reading the slides more time-consuming, this encouraged us to study their distribution in the healthy rectal submucosa, to simplify the diagnosis.Objectives: To develop a method that facilitates HD diagnosis by studying the distribution of ganglion cells in the submucosal plexus. Methods: Using the calretinin technique, we studied the distribution of plexuses in 60 fragments of rectal submu-cosa from 19 cadavers. After the study, the reading method created was used for diagnosis in 47 cases of suspected HD, using H&E staining. The accuracy was verified by comparing the results obtained with H&E to those obtained with the acetylcholinesterase technique, the golden standard in our laboratory.Results: The study of submucosal plexus distribution showed that just by examining the submucosal region every 20 mu m, approximately, it is possible to locate a ganglionic plexus, and we have already been able to diagnose HD with 93% accuracy. Conclusion: The study of ganglion cell distribution enabled the creation of a simplified method for reading the slides. The method applied achieved good accuracy and it can be used as an alternative method in HD diagnosis.
Palavras-chave
Hirschsprung 's Disease, Rectal biopsy, Ganglion cells, Submucosa
URI
https://observatorio.fm.usp.br/handle/OPI/53992
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Coleções
Artigos e Materiais de Revistas Científicas - FM/MPE
Artigos e Materiais de Revistas Científicas - HC/ICHC
Artigos e Materiais de Revistas Científicas - HC/ICr
Artigos e Materiais de Revistas Científicas - LIM/30