Calretinin immunohistochemistry in Hirschsprung's disease: An adjunct to formalin-based diagnosis

Abstract

Aim: This study was designed to assess the utility of calretinin immunohistochemistry in the diagnosis of Hirschsprung's disease.

Material and methods: Eleven definitive resection materials from 10 Hirschsprung's disease patients and 3 initial full-thickness rectal biopsies of these patients were retrieved from the pathology archives. Additionally, 15 distal colon and 13 proximal colon full-thickness samples from 23 non-Hirschsprung's disease patients were also evaluated as the control group. All material was reevaluated by light microscopy for the presence or absence of ganglion cells and immunostained with calretinin, including proximal surgical margins and aganglionic zone samples from each resection material.

Results: Immunohistochemistry for calretinin provided highly compatible results with hematoxylin-eosin findings in Hirschsprung's disease and non-Hirschsprung's disease patients, except in one Hirschsprung's disease patient with very rare nerve stainings at the distal surgical margin.

Conclusions: Calretinin immunohistochemistry was found to be highly sensitive and specific in detecting aganglionic segments. New research should be conducted in order to clarify calretinin staining patterns of the transitional zone, rare Hirschsprung's disease types, pure hypoganglionosis patients, and the anorectal junction, and for the mapping of fetal and neonatal colonic specimens. The technique seemed very effective for lowering the need for excessive sectioning and practical regarding the erratic nature of the acetylcholinesterase staining.