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Redefining Histological Cell Counts Using a Standardized Method: The Leuven Intestinal Counting Protocol.

Matthias Ceulemans1, Pauline Huyghe1, Gert De Hertogh2

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Clinical and Translational Gastroenterology
|June 18, 2024
PubMed
Summary
This summary is machine-generated.

A new software method improves the accuracy of counting duodenal eosinophils and mast cells. This standardized approach helps diagnose eosinophilic gastrointestinal diseases by establishing new thresholds for abnormal cell infiltration.

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Area of Science:

  • Gastroenterology
  • Histopathology
  • Digital Pathology

Background:

  • Diagnosis of eosinophilic gastrointestinal diseases relies on eosinophil counts, but standardized thresholds are lacking for the duodenum.
  • Methodological standardization is crucial for accurate diagnosis and patient management.

Purpose of the Study:

  • To develop a standardized workflow for duodenal cell quantification.
  • To estimate normal duodenal eosinophil and mast cell counts in healthy individuals.

Main Methods:

  • A software-based histological cell quantification method was developed and applied to digitized H&E-stained duodenal slides.
  • Inter-rater reliability was compared between software and microscopic methods, and reproducibility was validated in an independent cohort.
  • Eosinophil identification was compared to immunohistochemistry, and normal ranges for eosinophils and mast cells were determined in healthy controls.

Main Results:

  • Software-based quantification showed significantly improved reproducibility (ICC=0.909) compared to microscopy (ICC=0.796).
  • Duodenal eosinophils were more abundant around crypts than villi.
  • Normal ranges in healthy controls were established: mean eosinophils 228.8/mm², mast cells 419.5/mm² (95th percentile: eosinophils 402.8/mm², mast cells 707.6/mm²).

Conclusions:

  • A standardized, software-based approach for duodenal histological cell quantification was developed and validated.
  • This method is generalizable to various mucosal cell types.
  • Thresholds of 400 eosinophils/mm² and 700 mast cells/mm² were identified for abnormal duodenal infiltration.