Evaluation and specification of intraepithelial lymphocyte cut-off point with hematoxiline-eosine (H&E) and immunohistochemistry (CD3 marker) in duodenal biopsy of children with celiac disease

Abstract

Background: Some of studies showed intraepithelial lymphocyte and CD3 marker can be used in diagnosis of celiac disease with a high sensitivity and specificity, but there is controversy in these studies. This study aimed to evaluate and specify the cut-off point of intraepithelial lymphocyte with Hematoxiline-eosine (H&E) and immunohistochemistry (CD3 marker) in duodenal biopsy of children with celiac disease. Methods: In this cross-sectional study, 113 under 12-years-old children candidated for duodenal biopsy were enrolled. The number of intraepithelial lymphocytes in Hematoxiline-eosine and CD3 methods were determined, and based on pathology results, the cut-off points and diagnostic values of the two methods were calculated. Findings: The best cut-off points for Hematoxiline-eosine and CD3 methods was 16 and 18, respectively. The sensitivity, specificity, false positive, false negative, positive predictive value, negative predictive value, and accuracy were 93.8, 86.6, 13.4, 6.3, 53.6, 98.8, and 87.6 percent for Hematoxiline-eosine, and 87.5, 93.8, 6.2, 12.5, 70.0, 97.8, and 92.9 percent for CD3, respectively. Conclusion: Count of intraepithelial lymphocytes along with CD3 marker can help to detect celiac disease, especially when there is a controversy in between Hematoxiline-eosine and serology results. More studies is recommended to detect diagnostic values of these markers better. © 2018, Isfahan University of Medical Sciences(IUMS). All rights reserved.