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Evaluation of PGP9.5 in the diagnosis of Hirschsprung's disease
Author(s) -
Sams Virginia R.,
Bobrow Lynda G.,
Happerfield Lisa,
Keeling Jean
Publication year - 1992
Publication title -
the journal of pathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.964
H-Index - 184
eISSN - 1096-9896
pISSN - 0022-3417
DOI - 10.1002/path.1711680110
Subject(s) - lamina propria , pathology , staining , hirschsprung's disease , immunohistochemistry , ganglion , frozen section procedure , muscularis mucosae , enolase , medicine , biology , anatomy , epithelium , disease
The ability of an acetylcholinesterase‐stained frozen section to detect an increase in large cholinergic nerve fibres within the muscularis mucosae and extending into the lamina propria was a significant step forward in the diagnosis of Hirschsprung's disease (HD). However, such frozen section diagnosis is not always possible. The purpose of this study was to assess the ability of PGP9.5 to detect this pattern of mucosalnen/e fibre staining immunohistochemically. Sixtyfour specimens were included in the study. Twenty‐six of these had been diagnosed as HD by conventional means. All cases were stained immunohistochemically with PGP9.5, S100, and anti‐neurofilaments (NF). Twenty‐four cases of HD were also stained with neurone‐specific enolase (NSE). PGP9.5 reliably stained fibres in the mucosal and submucosal plexuses, and ganglion cells, when the latter were present. This positive staining of ganglion cells was more intense than that seen with NSE, and the positive fibre staining was more intense than that seen with NF. Increased lamina propria fibres were detected with PGP9.5 in only 37 per cent of HD cases compared with S100 positive staining in 60 per cent of cases. However, when S100 staining was assessed alone, it gave a higher false‐negative rate in diagnosing HD than PGP9.5 used alone. Therefore we would recommend the use of PGP9.5 and S100 together for the immunohistochemical diagnosis of HD in formalin‐fixed biopsies.