Differential expression of cell adhesion molecules in inflamed appendix: correlation with clinical stage

J Pathol. 1998 Dec;186(4):422-8. doi: 10.1002/(SICI)1096-9896(199812)186:4<422::AID-PATH209>3.0.CO;2-7.


The diagnosis of 'early inflamed', 'recurrent' or 'sub-acute' appendicitis is often difficult and accompanied by controversies between clinical data, histological findings, and their interpretation. The expression of the intercellular cell adhesion molecule-1 (ICAM-1), the vascular cell adhesion molecule-1 (VCAM-1), and E-selectin has been studied in 61 appendicectomy specimens for possible use as a diagnostic tool. This study demonstrates a different expression of CAM by endothelial (EC) and mesothelial cells (MC) in the various stages of appendicitis, with early E-selectin and ICAM-1 expression in EC, followed by VCAM-1 in EC and MC. Appendices from patients with prolonged clinical symptoms defined by clinicians as 'chronic' appendicitis showed VCAM-1 expression and occasionally weak expression of E-selectin in EC. In several cases, discrepancies were found between the pre-operative 'clinical' diagnosis, the histomorphological findings, and the immunohistological results. In this context, the expression of E-selectin and VCAM-1 in comparison with the histological features has potential significance in the diagnosis of 'early acute', 'sub-acute' or 'recurrent' appendicitis. In addition, a correlation was demonstrated between the histological stages of appendicitis and the kinetics of CAM expression. The study also indicates that the time course of E-selectin expression in vivo is longer than is suggested from in vitro data.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Disease
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Appendectomy
  • Appendicitis / metabolism*
  • Appendicitis / pathology
  • Cell Adhesion Molecules / metabolism*
  • Chronic Disease
  • E-Selectin / metabolism
  • Female
  • Humans
  • Immunoenzyme Techniques
  • Intercellular Adhesion Molecule-1 / metabolism
  • Male
  • Middle Aged
  • Recurrence
  • Vascular Cell Adhesion Molecule-1 / metabolism


  • Cell Adhesion Molecules
  • E-Selectin
  • Vascular Cell Adhesion Molecule-1
  • Intercellular Adhesion Molecule-1