Comparison of Immunohistochemical Expression of Calretinin, Map2, S-100 and Glut1 in Rectal Biopsies from Suspected Hirschsprung’s Disease

Abstract

Background: This study aimed to compare the immunohistochemical expression of calretinin, Map2, S-100, and Glut1 in rectal biopsy samples from patients suspected of Hirschsprung’s disease (HD).Methods and Results: Rectal biopsy samples from 40 patients with suspected HD were analyzed using hematoxylin and eosin (H&E) and immunohistochemistry (IHC). Immunohistochemical stains were assessed after previous routine histology interpretation, which was classified as “Positive or in favor for HD” and “Equivocal or negative for HD.” The staining patterns for calretinin, Map2, S-100, and Glut1 were analyzed regarding the following structures: lamina propria small nerve fibrils, submucosal small nerve fibrils,submucosal nerve fibers, and submucosal ganglia. The IHC stains for calretinin and Map2 were score-ranked as 0 – negative and 1 – positive. The IHC stain for S-100 was score-ranked as 0 – normal and 1 – hypertrophic. The IHC stain for Glut1 was ranked as 0 – normal perineural and 1 – conspicuous perineural accentuation Calretinin had 92% accuracy, the highest sensitivity (80%) and specificity (92.00%).Map2 also had the same accuracy as calretinin but lower sensitivity (46.67%). Regarding S-100 and Glut1, these two markers did not support a conclusive diagnosis. The accuracy for S-100 and Glut1 was 66.7% and 60%, respectively. Conclusion: Calretinin remains the currently most valuable single IHC marker in diagnosing difficult cases of HD.