Number of intraepithelial lymphocytes and presence of a subepithelial band in normal colonic mucosa differs according to stainings and evaluation method.

Autor:	Fiehn AK; Department of Pathology, Zealand University Hospital Roskilde, Sygehusvej 9, 4000 Roskilde, Denmark.; Department of Clinical Medicine, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen, Denmark., Engel PJH; Department of Pathology, Zealand University Hospital Roskilde, Sygehusvej 9, 4000 Roskilde, Denmark., Engel U; Department of Pathology, Copenhagen University Hospital Hvidovre, Kettegård Allé 30, 2650 Hvidovre, Denmark., Jepsen DNM; Department of Pathology, Zealand University Hospital Roskilde, Sygehusvej 9, 4000 Roskilde, Denmark.; Center for Surgical Science, Zealand University Hospital Køge, Lykkebækvej 1, 4600 Køge, Denmark., Blixt T; Department of Medical Gastroenterology, Zealand University Hospital Køge, Lykkebækvej 1, 4600 Køge, Denmark., Rasmussen J; Department of Medical Gastroenterology, Zealand University Hospital Køge, Lykkebækvej 1, 4600 Køge, Denmark., Wildt S; GastroUnit, Department of Medical Gastroenterology, Copenhagen University Hospital Hvidovre, Kettegård Allé 30, 2650 Hvidovre, Denmark., Cebula W; Department of Medical Gastroenterology, Zealand University Hospital Nykøbing Falster, Fjordvej 15, 4800 Nykøbing Falster, Denmark., Diac AR; Department of Medical Gastroenterology, Zealand University Hospital Nykøbing Falster, Fjordvej 15, 4800 Nykøbing Falster, Denmark., Munck LK; Department of Clinical Medicine, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen, Denmark.; Department of Medical Gastroenterology, Zealand University Hospital Køge, Lykkebækvej 1, 4600 Køge, Denmark.
Jazyk:	angličtina
Zdroj:	Journal of pathology informatics [J Pathol Inform] 2024 Mar 24; Vol. 15, pp. 100374. Date of Electronic Publication: 2024 Mar 24 (Print Publication: 2024).
DOI:	10.1016/j.jpi.2024.100374
Abstrakt:	Chronic watery diarrhea is a frequent symptom. In approximately 10% of the patients, a diagnosis of microscopic colitis (MC) is established. The diagnosis relies on specific, but sometimes subtle, histopathological findings. As the histology of normal intestinal mucosa vary, discriminating subtle features of MC from normal tissue can be challenging and therefore auxiliary stainings are increasingly used. The aim of this study was to determine the variance in number of intraepithelial lymphocytes (IELs) and presence of a subepithelial band in normal ileum and colonic mucosa, according to different stains and digital assessment. Sixty-one patients without diarrhea referred to screening colonoscopy due to a positive feacal blood test and presenting with endoscopically normal mucosa were included. Basic histological features, number of IELs, and thickness of a subepithelial band was manually evaluated and a deep learning-based algorithm was developed to digitally determine the number of IELs in each of the two compartments; surface epithelium and cryptal epithelium, and the density of lymphocytes in the lamina propria compartment. The number of IELs was significantly higher on CD3-stained slides compared with slides stained with Hematoxylin-and-Eosin (HE) ( p <0.001), and even higher numbers were reached using digital analysis. No significant difference between right and left colon in IELs or density of CD3-positive lymphocytes in lamina propria was found. No subepithelial band was present in HE-stained slides while a thin band was visualized on special stains. Conclusively, in this cohort of prospectively collected ileum and colonic biopsies from asymptomatic patients, the range of IELs and detection of a subepithelial collagenous band varied depending on the stain and method used for assessment. As assessment of biopsies from patients with diarrhea constitute a considerable workload in the pathology departments digital image analysis is highly desired. Knowledge provided by the present study highlight important differences that should be considered before introducing this method in the clinic. Competing Interests: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Lars Kristian Munck reports financial support to the study was provided by The Region Zealand Health Research Foundation. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. (© 2024 The Authors.)
Databáze:	MEDLINE
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