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HAEMATOXYLIN AND EOSIN STAINING IN THE DIAGNOSIS OF HODGKIN’S DISEASE IN UGANDA
Abstract
ABSTRACT
Background: Whereas immunohistochemical methods have been widely used for the
diagnosis and classification of Hodgkin’s Disease in the developed countries, there are
very few reports of their use in the developing countries where haematoxylin and eosin
is the mainstay of diagnosis of Hodgkin’s disease. Yet the diagnostic accuracy of
haematoxylin and cosin has not been assessed in Uganda.
Design: Laboratory based cross sectional study.
Objective: To determine the reliability of haematoxylin and eosin staining in the diagnosis
of Hodgkin’s disease using immunohistochemistry as the reference standard
Methodology: Two hundred and forty formalin fixed, paraffin embedded biopsies seen
in the Makerere University, Department of Pathology from 1980-2000 were studied. The
tissue sections, were assessed and subjected to immunohistochemical methods using
monoclonal antibodies including leucocyte common antigen, LCA (CD45), antibodies to
Reed-Sternberg cells (CD15, CD30) and antibodies to B cells (CD20). The sensitivity,
specificity, positive predictive value and negative predictive value were assessed. The
overall Kappa score was used to assess the agreement between the two diagnostic tests.
Results: Of the 240 biopsies, 171(71.3%) were confirmed as Hodgkin’s disease by
immunohistochemistry. Using haematoxylin and eosin (H&E), only 131 of the 171 cases
of Hodgkin’s disease were detected. The mean age of the 171 cases was 26.1 (SD 16.2)
years, with a mode of 20.0 and median of 22.5 years. The 15-24 year age group was
the most affected (47.2%). There were more males (65.9%) than females and most were
Baganda the dominant tribe in the central region. The sensitivity, specificity, positive
and negative predictive values of haematoxylin and cosin were 76.61%, 92.75%, 96.32%
and 61.53% respectively. The agreement between the two tests was 81.25% with an
overall measure of agreement, kappa, of 0.602.
Conclusion: Haematoxylin and cosin has relatively high efficacy in the diagnosis of
Hodgkin’s disease. Use of haematoxylin and cosin is still recommended for the diagnosis
of Hodgkin’s disease, reserving the expensive irrummohistochemistry for difficult cases.
Background: Whereas immunohistochemical methods have been widely used for the
diagnosis and classification of Hodgkin’s Disease in the developed countries, there are
very few reports of their use in the developing countries where haematoxylin and eosin
is the mainstay of diagnosis of Hodgkin’s disease. Yet the diagnostic accuracy of
haematoxylin and cosin has not been assessed in Uganda.
Design: Laboratory based cross sectional study.
Objective: To determine the reliability of haematoxylin and eosin staining in the diagnosis
of Hodgkin’s disease using immunohistochemistry as the reference standard
Methodology: Two hundred and forty formalin fixed, paraffin embedded biopsies seen
in the Makerere University, Department of Pathology from 1980-2000 were studied. The
tissue sections, were assessed and subjected to immunohistochemical methods using
monoclonal antibodies including leucocyte common antigen, LCA (CD45), antibodies to
Reed-Sternberg cells (CD15, CD30) and antibodies to B cells (CD20). The sensitivity,
specificity, positive predictive value and negative predictive value were assessed. The
overall Kappa score was used to assess the agreement between the two diagnostic tests.
Results: Of the 240 biopsies, 171(71.3%) were confirmed as Hodgkin’s disease by
immunohistochemistry. Using haematoxylin and eosin (H&E), only 131 of the 171 cases
of Hodgkin’s disease were detected. The mean age of the 171 cases was 26.1 (SD 16.2)
years, with a mode of 20.0 and median of 22.5 years. The 15-24 year age group was
the most affected (47.2%). There were more males (65.9%) than females and most were
Baganda the dominant tribe in the central region. The sensitivity, specificity, positive
and negative predictive values of haematoxylin and cosin were 76.61%, 92.75%, 96.32%
and 61.53% respectively. The agreement between the two tests was 81.25% with an
overall measure of agreement, kappa, of 0.602.
Conclusion: Haematoxylin and cosin has relatively high efficacy in the diagnosis of
Hodgkin’s disease. Use of haematoxylin and cosin is still recommended for the diagnosis
of Hodgkin’s disease, reserving the expensive irrummohistochemistry for difficult cases.
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