Diagnostic Utility of Calretinin Immunohistochemistry for the Diagnosis of Hirschsprung's Disease

Abstract

Objective: The aim of this study was to evaluate the diagnostic utility of calretinin immunostaining in colonic biopsy specimens in patients having a clinical suspicion of Hirschsprung's disease. Study Design: This study was a Cross sectional validation study. Place and Duration of Study: The study was conducted at Pakistan institute of medical sciences, Shaheed Zulfiqar Ali Bhutto Medical University (SZABMU), Islamabad, for a period of 11 months (December 2018 to November 2019). Materials and Methods: Sixty specimens from patients including multiple colonic biopsies and biopsies from rectum for doubted Hirschsprung's disease were evaluated. The biopsies were processed in Histopathology lab and Hematoxylin and eosin slides were examined. 30 ganglionic segments and 30 aganglionic segments along with control specimens were further stained with calretinin immunohistochemical marker and evaluated. Results: On Hematoxylin and eosin staining, 30 biopsies showed ganglion cells and 30 biopsies showed absence of ganglion cells. Calretinin immunohistochemistry was then evaluated on these ganglionic and aganglionic segments. In this study, sensitivity was found to be 91.4 % and a 100% of specificity was established. The positive predictive value and negative predictive value was found to be 100% and 89.2% respectively. Conclusion: Calretinin immunohistochemical marker can be applied on colonic and rectal biopsy specimens as a dependable and adjunctive tool for diagnosing Hirschsprung's disease, as it is easy and reliable to be used in daily practice.