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. 2012 Dec;57(12):3154-9.
doi: 10.1007/s10620-012-2249-6. Epub 2012 Jun 15.

Chromogranin A cell density as a diagnostic marker for lymphocytic colitis

Magdy El-Salhy  1 , Doris Gundersen, Jan G Hatlebakk, Trygve Hausken
Affiliations

Chromogranin A cell density as a diagnostic marker for lymphocytic colitis

Magdy El-Salhy et al. Dig Dis Sci. 2012 Dec.

Abstract

Background: Lymphocytic colitis (LC) can be mistakenly diagnosed as irritable bowel syndrome (IBS). In a previous study on IBS, some patients showed extremely high colonic chromogranin A cell density. Further examination of these patients showed that they suffered from LC.

Aims: To investigate whether chromogranin A cell density is increased in LC patients and to examine the possibility of using this increase as a marker for the diagnosis of LC.

Methods: Fifty-seven patients diagnosed with LC and 54 controls were included in the study. Biopsies from the right and left colon were obtained from both patients and controls, which were immunostained using the Avidin-biotin-complex method for chromogranin A, and cell density was quantified.

Results: In both the right and left colon of patients with LC, the density of chromogranin A was significantly higher than in controls. This increase in chromogranin A cells occurs whether the number of these cells is expressed as number/mm(2) epithelium or as number/field. Chromogranin A cell density for the right and left colon expressed as number of cells/mm(2) epithelium or as cell number/field showed a high sensitivity and specificity as a diagnostic marker for LC.

Conclusions: Chromogranin A is a common marker for endocrine cells, and the present finding suggests that colonic hormones are involved in the pathophysiology of LC. The chromogranin cell density seems to be a good diagnostic marker with high sensitivity and specificity in both the right and left colon, thus sigmoidoscopy can be used in the diagnosis of LC using with this marker.

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Figures

Fig. 1
Fig. 1
Chromogranin A-immunoreactive cells in the colon of a control (a) and a patient with lymphocytic colitis (b)
Fig. 2
Fig. 2
Chromogranin A cell density in the controls and patients with lymphocytic colitis as expressed per mm2 epithelium: in the right colon (a) and left colon (b). **p < 0.01, ***p < 0.001
Fig. 3
Fig. 3
Chromogranin A cell density expressed as he number of cells per field in controls and patients with lymphocytic colitis: in the right colon (a) and left colon (b). Symbols are the same as in Fig. 2
Fig. 4
Fig. 4
Receiver-operator characteristic (ROC) curve for chromogranin A cell density for the right (a) and left colon expressed as number of cells/mm2 epithelium (b)
Fig. 5
Fig. 5
ROC curve chromogranin A cell density in the right colon (a) and left colon (b), as expressed number of cells per field
See this image and copyright information in PMC

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