Abstract

Introduction: High Iron Diamine Alcian blue (HID-AB) is a well-established technique for demonstrating colonic acid mucins namely sulphomucins (brown- black) and sialomucins (blue). In certain colonic pathologies expression of sulphomucin, the predominant mucin in normal colonic epithelium is altered. Objective: To compare the changes in the pattern of mucin staining in, adenocarcinoma (AC), normal colonic epithelium, solitary rectal ulcer (SRU), transitional zone mucosa (TZ) (i.e.: normal non dysplastic mucosa adjacent to adenocarcinoma) and in ulcerative colitis (UC). Method: AC-21, normal colonic epithelium-30, SRU-23, TZ-20, UC-29 biopsies were stained with the HID-AB stain. Two investigators assessed the percentages of mucin staining by counting the number of cells staining for sulphomucin and sialomucin in an area of colonic epithelium measuring 1mm in length. The differences in these 5 categories were assessed for statistical significance using the one-way ANOVA test and a Post Hoc Comparison of the mean values was carried out to establish which groups were different. Results: ACs showed no sulphomucin or sialomucin staining while normal colonic epithelium showed nearly 100% sulphomucin staining. The percentage mean value for sulphomucin staining was AC-12.47%, normal colonic epithelium - 96.7%, SRU-35.7%, TZ-48.98%, and UC –75.43%. Hence the differences between these categories reached a level of statistical significance except between TZ and SRU. Conclusion: The patterns of mucin staining observed with HID/AB staining included relatively similar changes in mucin staining in the TZ and SRU, the loss acid mucin staining in AC and the relatively mild degree of sulphomucin loss in UC. Though there are significant differences in mucin staining between some of these colonic pathologies practical problems were encountered in using HID/AB as a diagnostic tool.

Highlights

  • High Iron Diamine Alcian blue (HID-AB) is a well-established technique for demonstrating colonic acid mucins namely sulphomucins and sialomucins

  • The patterns of mucin staining observed with HID/AB staining included relatively similar changes in mucin staining in the transitional zone mucosa (TZ) and solitary rectal ulcer (SRU), the loss acid mucin staining in AC and the relatively mild degree of sulphomucin loss in ulcerative colitis (UC)

  • ACs showed no sulphomucin or sialomucin staining while normal colonic epithelium showed nearly 100% sulphomucin staining

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Summary

Introduction

High Iron Diamine Alcian blue (HID-AB) is a well-established technique for demonstrating colonic acid mucins namely sulphomucins (brown- black) and sialomucins (blue). In certain colonic pathologies expression of sulphomucin, the predominant mucin in normal colonic epithelium is altered. Intestinal mucins are carbohydrate rich glycoproteins with a unique molecular structure and chemical properties [1]. The carbohydrate component is arranged in oligosaccharide chains of varying length and degree of branching. The gastrointestinal mucins in general are divided into neutral and acidic mucins. The intestinal mucins of both large and small intestine are acidic with gastric mucins being largely neutral [2]. The colonic mucins are known to be predominantly sulphated mucins while the small intestinal mucins are predominantly sialic in nature [3]

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