Clinicopathological correlations of neuroendocrine cell hyperplasia in ulcerative colitis patients

Abstract

Introduction. Several studies have shown that neuroendocrine cells (NECs) are increased in the colorectal mucosa of patients with ulcerative colitis (UC) compared to normal, mainly in the left colon. A threshold of 3.2 NECs/crypt has been proposed by some authors for defining NEC hyperplasia in these patients. However, correlations of NEC changes with clinical parameters have not been described. The objective of this study was to analyze NEC histological changes, described by several descriptors, in UC patients and identify relevant clinicopathological correlations. Material and methods. We analyzed colonic biopsies from 42 UC patients by highlighting the neuroendocrine cells with Chromogranin A immunohistochemical stain. Positive cells were detected and quantified by computerized image analysis, and their morphology and distribution were assessed. The data obtained were described as mean and maximum number of cells per crypt, and number of crypts showing linear hyperplasia. Results. Increased numbers of cryptic NECs were identified (mean 3.62/crypt). A rising trend was observed for Nancy grades 2 and 3 and a small decrease for grade 4 at the site of most severely active inflammation. However, linear hyperplasia negatively correlated with increase of Nancy and Geboes grades of histological inflammation (rho=-0.326, p=0.013; respectively rho=-0.368, p=0.005) and with age (rp=-0.328, p=0.039). The maximum counts per crypt correlated positively with corticosteroid treatment (rp=0,332, p=0.012). The mean count per crypt negatively correlated with disease duration ( rp=-0.388, p=0.013). Conclusion. NEC hyperplastic changes correlate with important clinical and histological parameters and could impact on the management of UC patients.

Keywords

• neuroendocrine cell hyperplasia
• linear hyperplasia
• ulcerative colitis
• histological score of inflammation