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Twenty-three neutrophil granulocytes in 10 high-power fields is the best histopathological threshold to differentiate between aseptic and septic endoprosthesis loosening

Identifieur interne : 001013 ( Main/Merge ); précédent : 001012; suivant : 001014

Twenty-three neutrophil granulocytes in 10 high-power fields is the best histopathological threshold to differentiate between aseptic and septic endoprosthesis loosening

Auteurs : Lars Morawietz [Allemagne] ; Obbe Tiddens [Allemagne] ; Michael Mueller [Allemagne] ; Stephan Tohtz [Allemagne] ; Tserenchunt Gansukh [Mongolie] ; Joerg H. Schroeder [Allemagne] ; Carsten Perka [Allemagne] ; Veit Krenn [Allemagne]

Source :

Histopathology [ 0309-0167 ] ; 2009.

RBID : Pascal:09-0247494

Descripteurs français

Pascal (Inist)
- Infection, Neutrophile, Granulocyte, Champ intense, Anatomopathologie, Histopathologie, Seuil, Endoprothèse, Immunohistochimie, Descellement.

English descriptors

KwdEn :
- Anatomic pathology, Endoprosthesis, Granulocyte, High field, Histopathology, Immunohistochemistry, Infection, Loosening, Neutrophil, Threshold.

Abstract

Aims: The histopathological diagnosis of infection in periprosthetic tissue from loose total joint endoprosthesis has been the subject of controversy. The aim was to define a histological criterion that would best differentiate between aseptic and septic endoprosthesis loosening. Methods and results: Neutrophilic granulocytes (NG) were enumerated histopathologically in 147 periprosthetic membranes obtained from aseptic and septic revision surgery, using periodic acid-Schiff (PAS) stains and CD15 immunohistochemistry. Cell numbers were correlated with the results of microbiological culture and the clinical diagnoses. Using receiver-operating characteristics, an optimized threshold was found at 23 NG in 10 high-power fields (HPF). Using this threshold, histopathological examination had a sensitivity of 73% and specificity of 95% when compared with microbiological diagnosis (area under the curve 0.881), and a sensitivity of 77% and specificity of 97% when compared with clinical diagnosis (area under the curve 0.891). Conclusions: We therefore recommend a counting algorithm with a threshold of ≥23 NG in 10 HPF (visual field diameter 0.625 mm) for the histopathological diagnosis of septic endoprosthesis loosening. If the enumeration of NG is difficult in conventional haematoxylin and eosin-stained slides, CD15 immunohistochemistry should be performed, whereas the PAS stain has not proven to be helpful.

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Le document en format XML

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<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Anatomic pathology</term>
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<term>Histopathology</term>
<term>Immunohistochemistry</term>
<term>Infection</term>
<term>Loosening</term>
<term>Neutrophil</term>
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<keywords scheme="Pascal" xml:lang="fr"><term>Infection</term>
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<term>Granulocyte</term>
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<front><div type="abstract" xml:lang="en">Aims: The histopathological diagnosis of infection in periprosthetic tissue from loose total joint endoprosthesis has been the subject of controversy. The aim was to define a histological criterion that would best differentiate between aseptic and septic endoprosthesis loosening. Methods and results: Neutrophilic granulocytes (NG) were enumerated histopathologically in 147 periprosthetic membranes obtained from aseptic and septic revision surgery, using periodic acid-Schiff (PAS) stains and CD15 immunohistochemistry. Cell numbers were correlated with the results of microbiological culture and the clinical diagnoses. Using receiver-operating characteristics, an optimized threshold was found at 23 NG in 10 high-power fields (HPF). Using this threshold, histopathological examination had a sensitivity of 73% and specificity of 95% when compared with microbiological diagnosis (area under the curve 0.881), and a sensitivity of 77% and specificity of 97% when compared with clinical diagnosis (area under the curve 0.891). Conclusions: We therefore recommend a counting algorithm with a threshold of ≥23 NG in 10 HPF (visual field diameter 0.625 mm) for the histopathological diagnosis of septic endoprosthesis loosening. If the enumeration of NG is difficult in conventional haematoxylin and eosin-stained slides, CD15 immunohistochemistry should be performed, whereas the PAS stain has not proven to be helpful.</div>
</front>
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<name sortKey="Krenn, Veit" sort="Krenn, Veit" uniqKey="Krenn V" first="Veit" last="Krenn">Veit Krenn</name>
<name sortKey="Mueller, Michael" sort="Mueller, Michael" uniqKey="Mueller M" first="Michael" last="Mueller">Michael Mueller</name>
<name sortKey="Perka, Carsten" sort="Perka, Carsten" uniqKey="Perka C" first="Carsten" last="Perka">Carsten Perka</name>
<name sortKey="Schroeder, Joerg H" sort="Schroeder, Joerg H" uniqKey="Schroeder J" first="Joerg H." last="Schroeder">Joerg H. Schroeder</name>
<name sortKey="Tiddens, Obbe" sort="Tiddens, Obbe" uniqKey="Tiddens O" first="Obbe" last="Tiddens">Obbe Tiddens</name>
<name sortKey="Tohtz, Stephan" sort="Tohtz, Stephan" uniqKey="Tohtz S" first="Stephan" last="Tohtz">Stephan Tohtz</name>
</country>
<country name="Mongolie"><noRegion><name sortKey="Gansukh, Tserenchunt" sort="Gansukh, Tserenchunt" uniqKey="Gansukh T" first="Tserenchunt" last="Gansukh">Tserenchunt Gansukh</name>
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Twenty-three neutrophil granulocytes in 10 high-power fields is the best histopathological threshold to differentiate between aseptic and septic endoprosthesis loosening

Twenty-three neutrophil granulocytes in 10 high-power fields is the best histopathological threshold to differentiate between aseptic and septic endoprosthesis loosening

Source :

Descripteurs français

English descriptors

Abstract

Links toward previous steps (curation, corpus...)

Links to Exploration step

Le document en format XML

Pour manipuler ce document sous Unix (Dilib)

Pour mettre un lien sur cette page dans le réseau Wicri