A new algorithm for histopathological diagnosis of periprosthetic infection using CD15 focus score and computer program CD15 Quantifier

Abstract

Introduction. A simple microscopic diagnostic quantification system for neutrophile granulocytes (NG) was developed evaluating a single focal point (CD15 focus score) which enables the detection of bacterial infection in SLIM (synoviallike interface membrane) Additionally a diagnostic algorithm is proposed how to use the CD15 focus score and the quantification software (CD15 Quantifier). Methods. 91 SLIM removed during revision surgery for histopathological diagnosis (hip; n=59 and knee; n=32) underwent histopathological classification according to the SLIM-consensus classification. NG where identified immunohistochemically by means of a CD15-specific monoclonal antibody exhibiting an intense granular cytoplasmic staining pattern. This pattern is different from CD15 expression in macrophages showing a pale and homogenous expression in mononuclear cells. The quantitative evaluation of CD15-positive neutrophils granulocytes (CD15NG) used the principle of maximum focal infiltration (focus) together with an assessment of a single focal point (approximately 0.3 mm2). This immunohistochemical data made it possible to develop CD15 Quantifier software which automatically quantifies CD15NG. Results. SLIM-cases with positive microbiological diagnosis (n=47) have significantly (p

Keywords

• метод cd15 focus score
• диагностика перипротезной инфекции
• автоматический количественный анализ
• классификация slim-консенсуса
• cd15 focus score
• periprosthetic joint infection
• automated image analysis
• slim-consensus-classification