{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T19:50:01Z","timestamp":1792698601011,"version":"4.5.0"},"reference-count":38,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,10,7]],"date-time":"2024-10-07T00:00:00Z","timestamp":1728259200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Histopathology"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:sec><jats:title>Aims<\/jats:title><jats:p>Diagnosis of coeliac disease (CD) with mild mucosal changes is difficult for all parties involved. We aimed to determine the power of T\u00a0cell receptor (TCR)\u03b3\u03b4<jats:sup>+<\/jats:sup> intra\u2010epithelial lymphocytes (IELs) in discriminating CD from other causes of intra\u2010epithelial lymphocytosis using a new monoclonal antibody.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 167 cases categorised as coeliac (117 untreated CD, classified according to Marsh, updated by Ensari, including 29 type 1, 29 type 2, 39 type 3 and 20 treated CD), and non\u2010coeliac groups (24 controls and 26 non\u2010coeliac IELosis) based on clinical, serological and histological data were studied for IEL counts enumerated per 100 enterocytes using haematoxylin and eosin, CD3, TCR \u03b4\u2010stains.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>TCR\u03b3\u03b4<jats:sup>+<\/jats:sup> IELs were significantly higher in CD (24.83\u2009\u00b1\u200916.13) compared to non\u2010CD (6.72\u2009\u00b1\u20096.32) and were correlated with the degree of mucosal damage. Both \u03b3\u03b4<jats:sup>+<\/jats:sup> IEL count and ratio showed higher performance in differentiating untreated coeliacs from controls, with a sensitivity of 83.76; 85.57 and specificity of 95.83; 79.17, respectively. TCR\u03b3\u03b4<jats:sup>+<\/jats:sup> IEL counts distinguished type 1 CD (20.41\u2009\u00b1\u200913.57) from non\u2010coeliac IELosis (9.42\u2009\u00b1\u20097.28) (<jats:italic>p<\/jats:italic>\u2009=\u20090.025). Discriminant analysis revealed that villus\/crypt ratio, \u03b3\u03b4<jats:sup>+<\/jats:sup> and CD3<jats:sup>+<\/jats:sup> IEL counts, \u03b3\u03b4<jats:sup>+<\/jats:sup>\/CD3<jats:sup>+<\/jats:sup>IEL ratio, IEL distribution pattern were potent discriminants and correctly classified 82.3% of cases while the algorithm accurately diagnosed 93.4% of cases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The new antibody detecting \u03b3\u03b4<jats:sup>+<\/jats:sup> IELs in FFPE sections revealed thresholds of 10.5 for \u03b3\u03b4<jats:sup>+<\/jats:sup> IELs and 14% for \u03b3\u03b4<jats:sup>+<\/jats:sup>\/CD3<jats:sup>+<\/jats:sup>IEL ratio which distinguished coeliacs from non\u2010coeliacs with high sensitivity and specificity, particularly in cases with normal villus\/crypt axis including type 1 CD, non\u2010CD IELosis and controls. A \u2018coeliac algorithm\u2019 based on \u03b3\u03b4<jats:sup>+<\/jats:sup> IELs is proposed with the hope that it will be used in the histopathological diagnostic approach by the pathology community.<\/jats:p><\/jats:sec>","DOI":"10.1111\/his.15330","type":"journal-article","created":{"date-parts":[[2024,10,8]],"date-time":"2024-10-08T02:59:47Z","timestamp":1728356387000},"page":"397-409","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["A new algorithm for coeliac disease based on the \u2018long forgotten\u2019 TCR\u03b3\u03b4<sup>+<\/sup> intra\u2010epithelial lymphocytes detected with an antibody working on FFPE sections"],"prefix":"10.1111","volume":"86","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8363-5068","authenticated-orcid":false,"given":"Eda N","family":"Kozan","sequence":"first","affiliation":[{"name":"Department of Pathology Ankara University Medical School  Ankara Turkey"},{"name":"Department of Pathology and Laboratory Medicine Weill Cornell Medicine  New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3192-1921","authenticated-orcid":false,"given":"Bilge A","family":"K\u0131rm\u0131z\u0131","sequence":"additional","affiliation":[{"name":"Department of Pathology Ankara University Medical School  Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3551-7267","authenticated-orcid":false,"given":"Ceyda T","family":"Kirsaclioglu","sequence":"additional","affiliation":[{"name":"Department of Pediatric Gastroenterology Ankara University Medical School  Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6266-3035","authenticated-orcid":false,"given":"Derya","family":"Gokmen","sequence":"additional","affiliation":[{"name":"Department of Biostatistics Ankara University Medical School  Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3971-1419","authenticated-orcid":false,"given":"Berna","family":"Savas","sequence":"additional","affiliation":[{"name":"Department of Pathology Ankara University Medical School  Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3133-9846","authenticated-orcid":false,"given":"Aydan","family":"Kansu","sequence":"additional","affiliation":[{"name":"Department of Pediatric Gastroenterology Ankara University Medical School  Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5971-4361","authenticated-orcid":false,"given":"Arif I","family":"Soykan","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Ankara University Medical School  Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7036-4457","authenticated-orcid":false,"given":"Arzu","family":"Ensari","sequence":"additional","affiliation":[{"name":"Department of Pathology Ankara University Medical School  Ankara 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