A Comparison of H&E Staining and IHC Study in Quantization of Duodenal Intra-Epithelial Lymphocytes

Duodenal biopsies are routinely obtained from suspected patients as a screening tool to evaluate the possibility of celiac diseases (CD). An increase in Intra-Epithelial Lymphocytes (IELs) is important in the diagnosis of CD and even in the presence of normal villous architecture may reflect gluten intolerance. The aim of this study was the comparison of two different histological staining Methods (H&E and IHC) for the quantization of duodenal IELs. This cross–sectional study was performed on 74 duodenal samples from April 2004 to September 2004 at Shariati hospital. All biopsies were stained with H&E and IHC Methods (LCA) and each one was twice examined for the quantization of IELs by pathologist taking use of single blinding. The mean number of IELs/100 epithelial cells in the first and second observations was 15.77 and 16.72 on H&E stained sections whereas it was 21.54 and 21.18 on IHC study. There was a linear correlation between IELs in H&E and IHC Methods. The comparison of mean IELs on H&E and LCA stained slides revealed about 5 cells preference for LCA. Two-step analysis of IELs quantization was suggested: 1) Estimation of IELs on H&E stained sections, and 2) LCA staining and counting, if IELs are suspected (upper limit of normal). When IHC staining was not performed it was possible to use the following formula:IELs on H&E +5 IELs on IHC.