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Immunohistochemistry for intestinal ganglion cells and nerve fibers: aid in the diagnosis of Hirschsprung's disease.

Hirschsprung's disease is a disease of congenital abnormalities characterized by absence of the enteric ganglion cell of the colon. To make a definite diagnosis, biopsy of the aganglionic zones of colon is required. A specimen from submucosal biopsy of the colon is very small and difficult to identify submucosal ganglion cells. Our study reports an immunohistochemical technique to detect submucosal ganglion cells. Six antineural markers, peripherin, cathepsin D, PGP 9.5, synaptophysin, chromogranin and S-100 protein, were used. The best antibody for the detection of submucosal ganglion cells in our study was peripherin. The additional measurement of nerve fiber caliber using S-100 protein staining is a valuable aid in the diagnosis of Hirschsprung's disease. It can be applied to the suction submucosal biopsy in a patient suspected of having Hirschsprung's disease, therefore, the complicated full thickness colonic and rectal biopsy can be avoided.