A Novel Objective Pathologic Criterion for Isolated Hypoganglionosis.


Journal

The American journal of surgical pathology
ISSN: 1532-0979
Titre abrégé: Am J Surg Pathol
Pays: United States
ID NLM: 7707904

Informations de publication

Date de publication:
10 May 2024
Historique:
medline: 10 5 2024
pubmed: 10 5 2024
entrez: 10 5 2024
Statut: aheadofprint

Résumé

Isolated hypoganglionosis (IHG) is histologically characterized by small numbers of myenteric ganglion cells and small myenteric ganglia; however, no numerical diagnostic criteria for IHG have been established. Therefore, this study aimed to develop quantitative pathologic criteria for IHG. We evaluated 160 resected intestinal tissue specimens from 29 pediatric autopsies and 10 IHG cases. These specimens were obtained from the jejunum, ileum, ascending colon, transverse colon, and rectum. Morphologic features of the myenteric ganglion cells and myenteric ganglia were quantified and analyzed in digitized HuC/HuD-immunostained and CD56-immunostained sections, respectively. Quantitative criteria were developed with a scoring system that used parameters with the area under the receiver operating characteristic curve (AUC) values >0.7 and sensitivity and specificity exceeding 70%. The selected parameters were the number of myenteric ganglion cells per cm and the number of myenteric ganglia with an area >2500 µm2per cm. The score for each parameter ranged from -1 to 2, and the total score of the scoring system ranged from -2 to 4. With a cutoff value of ≥2 (AUC, 0.98; 95% CI: 0.96-1.00), the scoring system had a sensitivity of 96% (95% CI: 0.82-1.00) and a specificity of 99% (95% CI: 0.95-1.00). We devised a novel pathologic criterion based on the quantification of the number of myenteric ganglion cells and ganglia. Furthermore, this criterion showed high diagnostic accuracy and could lead to a definitive diagnosis of IHG in clinical practice.

Identifiants

pubmed: 38726836
doi: 10.1097/PAS.0000000000002243
pii: 00000478-990000000-00347
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.

Déclaration de conflit d'intérêts

Conflicts of Interest and Source of Funding: The authors have disclosed that they have no significant relationships with, or financial interest in, any commercial companies pertaining to this article.

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Auteurs

Akihiko Tamaki (A)

Departments of Anatomic Pathology.
Pediatric Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka.

Kenichi Kohashi (K)

Department of Pathology, Graduate School of Medicine, Osaka Metropolitan University, Osaka.

Koichiro Yoshimaru (K)

Fukuoka College of Health Sciences, Fukuoka, Japan.

Yuko Hino (Y)

Departments of Anatomic Pathology.
Pediatric Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka.

Hiroshi Hamada (H)

Departments of Anatomic Pathology.
Pediatric Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka.

Naonori Kawakubo (N)

Pediatric Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka.

Tomoaki Taguchi (T)

Division of Pediatric Gastroenterology, Hepatology and Nutrition, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.

Tatsuro Tajiri (T)

Pediatric Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka.

Yoshinao Oda (Y)

Departments of Anatomic Pathology.

Classifications MeSH