Comparison of Histopathologic Findings in Duodenal and Ileal Endoscopic Biopsies in Dogs with Chronic Small Intestinal Enteropathies
Comparison of Histopathologic Findings in Duodenal and Ileal Endoscopic Biopsies in Dogs with Chronic Small Intestinal Enteropathies
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DOI：
10.1111/jvim.12041
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发表时间：
2013-03-01
影响因子：
2.6
通讯作者：
Allenspach, K.
中科院分区：
文献类型：
--
作者：
Procoli, F.;Motskuela, P. F.;Allenspach, K.
背景目前对有慢性上消化道症状的犬只进行内镜检查和十二指肠活检是一种趋势。这种方法可能导致忽视重要的回肠病变，影响临床治疗。目的比较慢性肠病犬并发十二指肠和回肠内镜活检，并评价其与临床病理表现的相关性。38只狗患有慢性肠病。方法回顾性分析十二指肠和回肠活检。9个组织学变量，5个结构变量（绒毛发育不良、上皮损伤、隐窝膨胀、乳膨大、粘膜纤维化）和4个炎症变量（上皮内淋巴细胞、固有层淋巴细胞和浆细胞、嗜酸性粒细胞和中性粒细胞）进行评分。评估临床严重程度评分和相关临床病理变量。结果十二指肠和回肠组织学评分只有轻微的一致性（=0.003）。除了粘膜纤维化（=0.44）外，形态学和炎症变量之间存在轻微的一致。十二指肠隐窝扩张（P= 0.031）、回肠泌乳扩张（P= 0.038）、回肠黏膜淋巴浆细胞性炎症（P= 0.035）与临床严重程度有统计学意义。低白蛋白血症与回肠泌乳扩张（P= 0.033）和回肠上皮内淋巴细胞数量（P= 0.019）有显著相关性。低钴胺血症与回肠上皮内淋巴细胞数量有统计学意义（P= 0.012）。结论及临床意义在调查有慢性上消化道体征的犬时，建议同时进行十二指肠和回肠内镜活检。
Background The current tendency when investigating dogs with chronic upper gastrointestinal signs is to perform endoscopy and biopsy only the duodenum. This approach could lead to overlooking important ileal lesions and affect the clinical management. Objectives To compare concurrent duodenal and ileal endoscopic biopsies in dogs with chronic enteropathies and evaluate their correlation with clinicopathologic findings. Animals Thirty-eight dogs with chronic enteropathies. Methods Duodenal and ileal biopsies were retrospectively reviewed. Nine histologic variables, 5 structural (villous stunting, epithelial injury, crypt distension, lacteal dilatation, and mucosal fibrosis) and 4 inflammatory (intraepithelial lymphocytes, lamina propria lymphocytes and plasma cells, eosinophils, and neutrophils) were scored. Clinical severity scores and relevant clinicopathologic variables were evaluated. Results There was only slight agreement between duodenal and ileal histologic scores (=0.003). There was slight agreement between the presence of any of the morphological and inflammatory variables, with the exception of mucosal fibrosis (=0.44). Statistically significant correlation was found between clinical severity and duodenal crypt distension (P=.031), ileal lacteal dilatation (P=.038), and ileal mucosal lymphoplasmacytic inflammation (P=.035). A significant correlation was found between hypoalbuminemia and ileal lacteal dilatation (P=.033) and number of ileal intraepithelial lymphocytes (P=.019). A statistically significant correlation was found between hypocobalaminemia and number of ileal intraepithelial lymphocytes (P=.012). Conclusions and Clinical Importance When investigating dogs with chronic upper gastrointestinal signs, the collection of concurrent duodenal and ileal endoscopic biopsies is recommended.