Calretinin、S100免疫组化染色诊断先天性巨结肠的价值  

The Value of Calretinin and S100 Immunohistochemical Staining in the Diagnosis of Hirschsprung’s Disease

作　　者：张云鹤 张君娜 Zhang Yunhe;Zhang Junna(Department of Pathology,No.1 Affiliated Hospital of Henan University,Kaifeng 475000)

机构地区：[1]河南大学第一附属医院病理科,开封475000

出　　处：《数理医药学杂志》2022年第9期1265-1268,共4页Journal of Mathematical Medicine

基　　金：河南省医学科技攻关计划(联合共建)项目(编号:LHGJ20190528)。

摘　　要：目的:探讨钙视网膜蛋白(Calretinin)和S100免疫组化染色诊断先天性巨结肠(HD)的临床价值。方法:研究选取127例疑似HD患儿展开研究,资料收集时间在2018年5月-2020年12月,标本采集患儿病变肠段近端扩张段和远端狭窄段处组织,依次进行S100免疫组化染色和Calretinin检查,以乙酰胆碱酯酶染色结果为金标准,比较上述两种检测方式单独和联合检测的诊断价值。结果:Calretinin染色阳性率66.93%、S100免疫组化染色阳性率68.50%、联合检测阳性率70.87%、金标准检测阳性率77.17%,4种检测方式对比无明显差异(P>0.05)。联合检测的特异性、敏感性、阳性和阴性预测值(86.21%、87.76%、95.56%、67.57%)均高于Calretinin染色(51.72%、72.45%、83.53%、35.71%)和S100免疫组化染色(58.62%、76.53%、86.21%、42.5%),差异有统计学意义(P<0.05)。联合检测和金标准检测均为阳性的86例患儿中,联合检测检出扩张段55例、狭窄段31例;金标准检出扩张段59例,狭窄段27例,两者对比Kappa值0.844,一致性良好,符合率为93.02%。结论:S100免疫组化染色联合Calretinin诊断HD的诊断效能更高,并且在扩张段和狭窄段的检出情况与金标准有较高的一致性和符合率,临床诊断价值颇高。Objective:To explore the application value ofcalretinin and S100 immunohistochemical staining in the diagnosis of neonatal Hirschsprung’s disease(HD).Methods:127 children with suspected HD were selected for the study.The data were collected from May 2018 to December 2020.The tissue samples of proximal dilated segment and distal stenotic segment of the diseased intestinal segment were collected.Calretinin and S100 immunohistochemical staining were performed in turn.The results of acetylcholinesterase staining were taken as the gold standard,and the diagnostic value of the two methods alone and in combination were compared.Results:The positive rates of calretinin staining,S100 immunohistochemical staining,combined detection and gold standard detection were 66.93%,68.50%,70.87% and 77.17%,respectively,with no statistical significance(P>0.05).The specificity,sensitivity,positive and negative predictive values of combined detection(86.21%,87.76%,95.56%,67.57%)were higher than those of calretinin staining(51.72%,72.45%,83.53%,35.71%)and S100immunohistochemical staining(58.62%,76.53%,86.21%,42.5%),and the difference was statistically significant(P<0.05).Among the 86children who were detected positive by combined test and gold standard test,55cases of dilated segment and 31cases of stenotic segment were detected by combined test;The gold standard detected 59cases of dilated segment and 27cases of stenotic segment.The Kappa value of the two groups was 0.844,with good consistency,and the coincidence rate was 93.02%.Conclusion:In the diagnosis of neonatal HD,the diagnostic efficiency of calretinin and S100immunohistochemical staining combined detection is higher than that of the two staining methods alone,and the detection situation of combined detection in the dilated segment and stenotic segment has a high consistency and coincidence rate with the gold standard,which has quite high clinical diagnostic value.

关 键 词：新生儿 先天性巨结肠 乙酰胆碱酯酶染色 S100免疫组化染色 CALRETININ 诊断效能 

分 类 号：R446.6[医药卫生—诊断学]