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[Proliferating cell nuclear antigen (PCNA) in patients with malabsorption syndrome: comparative study with
1Unidad de Anatomia Patológica, Facultad de Medicina, Universidad de La Frontera, Temuco, Chile.
Insights
Proliferating cell nuclear antigen (PCNA) immunostaining aids in diagnosing pediatric celiac disease. This method quantifies crypt cell proliferation, revealing architectural changes in the small intestine for better diagnostic accuracy.
Area of Science:
- Pediatric Gastroenterology
- Histopathology
- Immunohistochemistry
Background:
- Small bowel biopsy analysis is crucial for diagnosing malabsorption syndromes in children.
- Assessing mucosal architecture and cellular proliferation provides key diagnostic insights.
Purpose of the Study:
- To evaluate the utility of morphometric analysis and PCNA immunostaining in pediatric small intestinal biopsies.
- To correlate crypt proliferative activity with architectural changes in giardiasis, malnutrition, and celiac disease.
Main Methods:
- Performed morphometric analysis and PCNA immunostaining on small intestinal biopsies from 16 children (8 months to 6 years).
- Analyzed biopsies from children with giardiasis, primary malnutrition, and celiac disease.
- Correlated PCNA positivity extent with the degree of architectural disorder (mucosal index).
Main Results:
- PCNA positivity was observed in the lower crypt portions, with varying heights across conditions (giardiasis: 156µm, malnutrition: 103µm, celiac disease: 182µm).
- Celiac disease showed significantly higher PCNA positivity compared to primary malnutrition (p < 0.01).
- A significant negative correlation existed between architectural disorder and crypt proliferative activity (PCNA(+) crypts).
Conclusions:
- Morphometric analysis and PCNA immunostaining are valuable adjuncts to standard histopathology for small bowel mucosa.
- These techniques can effectively assess architectural disorder and proliferative activity, aiding in celiac disease diagnosis.
- PCNA immunostaining highlights differences in crypt cell proliferation among pediatric malabsorption conditions.
Abstract:
The study of small bowel mucosa is routine in the study of patients with malabsorption. We report 16 children aged from 8 months to 6 years old (2 with giardiasis, 8 with primary malnutrition and 5 with celiac disease) in whom a morphometric and PCNA immunostaining was performed in the small intestinal biopsy. Positivity for PCNA was found in the lower portion of the crypts reaching 156 microns of heigh in patients with giardiasis, 103 microns in primary malnutrition and 182 microns in celiac disease (p < 0.01 compared to primary malnutrition). A negative and significant correlation was found between the degree of architectural disorder (expressed the mucosal index) and the proliferative portion of the crypts (expressed as the percentage of PCNA(+) crypts. We propose these methods as complements to the small bowel mucosa histopathological study in the diagnosis of celiac disease, to assess the degree of architectural disorder and the proliferative activity.