NEUROENDOCRINE CELL HISTOLOGY CHANGES IN THE EVOLUTION OF ULCERATIVE COLITIS
NEUROENDOCRINE CELL HISTOLOGY CHANGES IN THE EVOLUTION OF ULCERATIVE COLITIS

Summary/Abstract: BACKGROUND AND AIM: NEUROENDOCRINE CELLS (NECS) HAVE BEEN IN FOCUS RECENTLY IN SEVERAL STUDIES ON PATIENTS WITH INFLAMMATORY BOWEL DISEASE SHOWING INCREASED NUMBERS IN THE CRYPTS AND SOMETIMES IN THE MUCOSAL LAMINA PROPRIA. THE AIM OF THIS STUDY WAS TO ASSESS HOW NEC HISTOLOGY CHANGES IN ULCERATIVE COLITIS (UC) PATIENTS OVER TIME AND THE POTENTIAL IMPLICATIONS THESE ALTERATIONS MAY HAVE.MATERIAL AND METHODS: WE RETROSPECTIVELY SEARCHED FOR UC PATIENTS WITH MULTIPLE PRESENTATIONS IN THE PATHOLOGY DEPARTMENT OF ELIAS UNIVERSITY EMERGENCY HOSPITAL IN THE LAST THREE YEARS AND IDENTIFIED 9 PATIENTS WITH COLONIC BIOPSIES TAKEN AT TWO OR THREE DIFFERENT TIMES IN THE EVOLUTION OF THE DISEASE. NECS WERE DETECTED BY IMMUNOHISTOCHEMISTRY USING CHROMOGRANIN A ANTIBODY. WE COUNTED THE NEC PER CRYPT AND EVALUATED THE PRESENCE OF LINEAR HYPERPLASIA. RESULTS:WE IDENTIFIED A DEFINITE INCREASE IN NECS IN MOST UC PATIENTS, PARTICULARLY AT THE ONSET OF THE DISEASE, FOLLOWED BY A SIGNIFICANT DECREASE OVER TIME AS DEMONSTRATED BY THE MODERATE NEGATIVE CORRELATIONS DETECTED BY PEARSON’S TEST BETWEEN THE DURATION OF DISEASE AND BOTH THE MEAN (RP=- 517, P=0.014) AND MAXIMUM NUMBER OF NECS PER CRYPT (RP=- 557, P=0.007). LINEAR HYPERPLASIA IN THE HOTSPOT SHOWED A SIMILAR DECREASING TREND, BUT WITHOUT STATISTICAL SIGNIFICANCE ON OUR SAMPLE (RP=- 388, P=0.074).CONCLUSIONS: THERE IS AN INCREASE OF NECS IN UC PATIENTS, HALF OF THEM SHOWING LINEAR HYPERPLASIA. FINDINGS OF NEC HYPERPLASIA AT THE ONSET OF DISEASE COULD HELP WITH THE INITIAL HISTOLOGICAL DIFFERENTIAL DIAGNOSIS OF UC WHEN THE CLASSICAL HISTOLOGICAL ASPECTS ARE NOT PRESENT.

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