TY  - BOOK
AU  - 
AU  - 
AU  - 
TI  - The Utility of Hematoxylin and Eosin Stain and S100 Compared to Calretinin On Tissue Blocks Suspected with Hirschsprung’s Disease at Bugando Medical Centre, Mwanza, Tanzania. 
PY  - 2024///.
CY  - Mwanza, Tanzania |
PB  - Catholic University of Health and Allied Sciences [CUHAS-Bugando] |
KW  -  
N2  - 

Abstract:

Background: Hirschsprung's disease (HD) is a congenital disorder characterized by the absence of ganglion cells in the part of the bowel leading to functional obstruction. Accurate and timely diagnosis of this condition is crucial for appropriate management and improved patient outcomes. Hematoxylin and Eosin (H&E) staining, S100, and calretinin staining are commonly used techniques for the diagnosis of Hirschsprung's disease. Calretinin is a gold standard and has better accuracy in the diagnosis of HD, but its availability and cost make it a limiting factor compared to routinely available H&E and S100 stains in histopathology laboratories. This study aims to establish the utility of H&E and S100 on the diagnosis of HD compared to the gold standard, calretinin, at Bugando Medical Centre in Mwanza, Tanzania.

Objective: To determine the diagnostic utility between Hematoxylin and Eosin (H&E), S100 staining compared with Calretinin staining for the diagnosis of Hirschsprung's disease at Bugando Medical Centre in Mwanza, Tanzania between January 2020 and December 2022.

Methodology: The retrospective cross-sectional study that was conducted between November 2023 to May 2024. It included all cases suspected clinically to have Hirschsprung's disease at Bugando Medical Centre in Mwanza, Tanzania. A total number of 122 cases suspected clinically for HD were retrieved from the hospital patients’ management system . Out of that 106 cases stained for both Haematoxylin and Eosin, Calretinin IHC and S100 IHC.The slide were evaluated by residents and the two pathologists and the diagnostic value was determined in comparison with gold standard Calretinin IHC . A statistical analysis by STATA version 15vl was done to assess the agreement, sensitivity, and specificity of H&E, S100 staining compared to Calretinin staining in the diagnosis of Hirschsprung’s disease.

Results: The overall concordance of S100 and Calretinin IHC was found to be 65.1 % and the discordance rate was 34.9 with Cohen’s Kappa agreement of 0.59 (moderate agreement). The sensitivity of S100 was 38%, and specificity of 92%, with a positive predictive value of 84% and negative predictive value of 59%, while that with H&E and Calretinin was found to be 83.9 % and the discordance rate was 16.1% with Cohen’s Kappa agreement of 0.67(substantial agreement). The combined sensitivity and specificity of H&E and S100 to be 58.4% and 100% respectively.

Conclusion: H&E staining showed high sensitivity and specificity of 85% and 82% respectively compared to S100 IHC with sensitivity and specificity of 38% and 92% when both compared to calretinin IHC for the diagnosis of HD. Therefore H&E can still be used in the diagnosis of HD over S100 in the absence of the gold standard calretinin IHC. S100 can be combined with H&E for diagnosis in order to increase its sensitivity and specificity.


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