Comparison of histological parameters for the diagnosis of eosinophilic oesophagitis versus gastro-oesophageal reflux disease on oesophageal biopsy material
Comparison of histological parameters for the diagnosis of eosinophilic oesophagitis versus gastro-oesophageal reflux disease on oesophageal biopsy material
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DOI：
10.1111/j.1365-2559.2008.03187.x
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发表时间：
2008-12-01
期刊：
影响因子：
6.4
通讯作者：
Stolte, M.
中科院分区：
文献类型：
--
作者：
Mueller, S.;Neureiter, D.;Stolte, M.
嗜酸性食管炎（EO）与胃食管反流病（GORD）活检组织学参数的比较嗜酸性食管炎（EO）的主要病理形态学改变是食管上皮的嗜酸性粒细胞浸润，但胃食管反流病（GORD）也与嗜酸性粒细胞增多有关。目的是比较常规活检标本中EO和GORD诊断的组织学参数。74例患者的105例常规活检标本中EO（n = 62），GORD（n = 24）和可能EO（n = 19）（52名男子，22名妇女;平均年龄43.7岁）分析嗜酸性粒细胞，肥大细胞，使用嗜酸性粒细胞过氧化物酶和嗜酸性粒细胞主要碱性蛋白和肥大细胞类胰蛋白酶的单克隆抗体的免疫组织化学，观察食管上皮的脱颗粒和定性变化。在苏木精-伊红染色（54.8 vs. 9.1; P < 0.05）和免疫组化（77.5 vs. 24.7; P < 0.05）上，EO组嗜酸性粒细胞浸润显著高于GORD组。嗜酸性粒细胞脱颗粒在EO组比GORD组明显更强烈（1.16比0.41; P < 0.05）。EO与GORD的组织学鉴别诊断应根据嗜酸性粒细胞计数、嗜酸性粒细胞和食管鳞状上皮的继发性形态学改变，尤其是可疑EO的病例。
Comparison of histological parameters for the diagnosis of eosinophilic oesophagitis versus gastro-oesophageal reflux disease on oesophageal biopsy materialEosinophil infiltration of the oesophageal epithelium is the cardinal pathomorphological finding in eosinophilic oesophagitis (EO), but gastro-oesophageal reflux disease (GORD) is also associated with increased eosinophils. The aim was to compare histological parameters for the diagnosis of EO versus GORD on routinely taken biopsy specimens.One hundred and five routine biopsy specimens with EO (n = 62), GORD (n = 24) and probable EO (n = 19) from 74 patients (52 men, 22 women; mean age 43.7 years) were analysed for numbers of eosinophils, mast cells, degranulation and qualitative changes of oesophageal epithelium using immunohistochemistry with monoclonal antibodies against eosinophil peroxidase and eosinophil major basic protein and mast cell tryptase. Eosinophil infiltration was significantly higher in EO than in GORD both on haematoxylin and eosin staining (54.8 versus 9.1; P < 0.05) and immunohistochemistry (77.5 versus 24.7; P < 0.05). Eosinophil degranulation was significantly more intense in EO than in GORD (1.16 versus 0.41; P < 0.05). Furthermore, eosinophilia-codependent secondary qualitative changes of squamous epithelium in EO were generally more extensive than those in GORD.Histological differential diagnosis of EO and GORD should be based on eosinophil counts, secondary morphological changes of eosinophils and oesophageal squamous epithelium, especially in cases suspicious of EO.