Comparison of different pathological markers in predicting pyeloplasty outcomes in children
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Read the article on jpedsurg.org ↗Article · Sep 2019 · 1 min read
In brief
In brief
This study of 31 pediatric UPJO patients demonstrates that collagen-to-muscle ratio is the strongest histopathological predictor of pyeloplasty success (r=-0.94), outperforming ICC and neuron density markers. Pathological analysis of the anastomosed ureteral segment correlates better with 1-year outcomes than UPJ tissue itself, with CM ratio <1.5 predicting favorable results.
Written by the GCMD Library team from the article.
Purpose
To compare the efficacy of pathological markers like Interstitial cells of Cajal (ICC), neurons and Collagen to Muscle ratio (CM ratio), in predicting pyeloplasty outcomes.
Methods
Histological sections from 31 patients with UPJO were analyzed for ICC & neurons on immuno-histochemistry and CM ratio on Masson's trichrome staining. Post-operative outcomes were analyzed at 1-year follow up; expressed as excellent, moderate or mild improvement, static and deterioration based on the three factors: ultrasound grade, differential renal function and renogram drainage pattern. The pathological findings were correlated with clinical outcomes.
Results
The study group (n = 31) had a mean age 2.9 (0.6) years (M: F = 22:9). UPJ segment had significantly less ICC/neurons and more collagen compared to normal ureter (p = 0.001). Pathological parameters at the anastomosed end of ureter had a better correlation than those at UPJ with clinical outcome. CM ratio with a stronger correlation (r = − 0.94; p = 0.001) was a better predictor of prognosis than ICC (r = 0.76; p = 0.01) or neuron (r = 0.83; p = 0.01) density. ICC >10/HPF, neurons >6/HPF and CM ratio