Tryptase staining of mast cells may differentiate eosinophilic esophagitis from gastroesophageal reflux disease.
Tryptase staining of mast cells may differentiate eosinophilic esophagitis from gastroesophageal reflux disease.
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DOI：
10.1038/ajg.2010.412
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发表时间：
2011-02
影响因子：
9.8
通讯作者：
Shaheen, Nicholas J.
中科院分区：
文献类型：
--
作者：
Dellon, Evan S.;Chen, Xiaoxin;Miller, C. Ryan;Fritchie, Karen J.;Rubinas, Tara C.;Woosley, John T.;Shaheen, Nicholas J.
肥大细胞可能参与嗜酸性粒细胞性食管炎（EoE）的发病机制，但其在诊断中的作用尚不清楚。我们的目的是确定食管肥大细胞的类胰蛋白酶染色是否可以区分 EoE 和 GERD，并可用于诊断 EoE。我们进行了一项病例对照研究，将共识指南定义的 EoE 患者与食管活检中出现嗜酸性粒细胞的 GERD 患者进行比较。使用肥大细胞类胰蛋白酶进行免疫组织化学。在掩盖诊断后，比较各组之间肥大细胞染色的密度（肥大细胞/mm2）和强度（0-4 等级）。构建受试者工作特征（ROC）曲线，并计算曲线下面积（AUC）以评估肥大细胞染色，作为独立的诊断测试和嗜酸性粒细胞计数的辅助测定。对 54 名 EoE（平均年龄：24 岁；69% 男性；平均 146 eos/hpf）和 55 名 GERD（平均年龄 34；60% 男性；平均 20 eos/hpf）患者进行了分析。 EoE 中的最大上皮类胰蛋白酶密度高于 GERD（162 ± 87 个肥大细胞/mm2 vs 67 ± 54；p<0.001）。肥大细胞在整个活检中广泛分布，EoE 患者多于 GERD 患者（41% vs 7%；p<0.001）。类胰蛋白酶密度和嗜酸性粒细胞计数仅呈弱相关（R2=0.09；p=0.002）。单独类胰蛋白酶染色的 AUC 为 0.84，肥大细胞和嗜酸性粒细胞组合的 AUC 为 0.96。与 GERD 患者相比，EoE 患者的类胰蛋白酶阳性肥大细胞水平更高，这提高了活检的诊断价值，超越了单独的嗜酸性粒细胞计数。肥大细胞类胰蛋白酶可用作 EoE 的诊断测定。
Mast cells may contribute to the pathogenesis of eosinophilic esophagitis (EoE), but their role in diagnosis is unknown. Our aim was to determine whether tryptase staining of esophageal mast cells differentiates EoE from GERD and has utility for diagnosis of EoE. We performed a case-control study comparing patients with EoE, defined by consensus guidelines, to GERD patients with eosinophils on esophageal biopsy. Immunohistochemistry was performed with mast cell tryptase. The density (mast cells/mm2) and intensity (0–4 scale) of mast cell staining was compared between groups after masking the diagnosis. Receiver operating characteristic (ROC) curves were constructed, and the area under the curve (AUC) calculated to assess mast cell staining as both a stand-alone diagnostic test and an adjunctive assay with eosinophil counts. Fifty-four EoE (mean age: 24; 69% male; mean 146 eos/hpf) and 55 GERD (mean age 34; 60% male; mean 20 eos/hpf) patients were analyzed. The maximum epithelial tryptase density was higher in EoE than in GERD (162 ± 87 mast cells/mm2 vs 67 ± 54; p<0.001). Mast cells were diffusely distributed throughout the biopsy in more EoE than GERD patients (41% vs 7%; p<0.001). Tryptase density and eosinophil count were only weakly correlated (R2=0.09; p=0.002). The AUC was 0.84 for tryptase staining alone, and 0.96 for the combination of mast cells and eosinophils. Patients with EoE have higher levels of tryptase positive mast cells compared to GERD patients, improving the diagnostic value of biopsies beyond eosinophil counts alone. Mast cell tryptase may have utility as a diagnostic assay for EoE.
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影响因子：
14.2
作者：
Abonia, J. Pablo;Blanchard, Carine;Butz, Bridget Buckmeier;Rainey, Heather F.;Collins, Margaret H.;Stringer, Keith;Putnam, Philip E.;Rothenberg, Marc E.
通讯作者：
Rothenberg, Marc E.
影响因子：
9.8
作者：
Ngo, P;Furuta, GT;Fox, VL
通讯作者：
Fox, VL
DOI：
10.1097/01.mpg.0000188740.38757.d2
发表时间：
2006-01-01
影响因子：
2.9
作者：
Gupta, SK;Fitzgerald, JF;HogenEsch, T
通讯作者：
HogenEsch, T
影响因子：
6.4
作者：
Mueller, S.;Neureiter, D.;Stolte, M.
通讯作者：
Stolte, M.
影响因子：
9.8
作者：
Rodrigo, Sonall;Abboud, Gebran;Chandrasoma, Parakrama
通讯作者：
Chandrasoma, Parakrama