Histological and magnified endoscopic evaluation of villous atrophy in gastrointestinal graft-versus-host disease.
Histological and magnified endoscopic evaluation of villous atrophy in gastrointestinal graft-versus-host disease.
复制标题
胃肠道移植物抗宿主病中绒毛萎缩的组织学和放大内镜评估。
DOI：
10.1007/s00277-020-03966-y
复制
发表时间：
2020
期刊：
影响因子：
--
通讯作者：
Sakamoto N.
中科院分区：
文献类型：
--
作者：
Matsuda K;Ono S;Tanaka I;Inoue M;Kinowaki S;Ishikawa M;Tsuda M;Yamamoto K;Shimizu Y;Takahashi S;Hayase E;Hashimoto D;Teshima T;Sakamoto N.
目的：测量组织学绒毛萎缩并阐明内镜下绒毛萎缩在胃肠道移植物抗宿主病中的诊断准确性。研究方法：回顾性收集造血干细胞移植后接受上和/或下内镜检查的患者的数据。在研究1中，A组包括56名组织学证实为GI-GVHD的患者，B组包括60名组织学未证实为GI-GVHD的患者。C组为HSCT前患者59例。组织学测量十二指肠和回肠末端绒毛和隐窝的长度。在研究2中，使用放大内镜诊断十二指肠和回肠末端绒毛萎缩的准确性进行了评价。结果如下：研究1中，A组十二指肠和回肠末端的绒毛长度和绒毛/隐窝（V/C）比值显著小于其他各组（p< 0.05）。V/C比值与回肠末端的临床严重程度、组织学分级和内镜分级中度相关。在研究2中，放大图像对绒毛萎缩的诊断准确率在十二指肠为83.8%，在回肠末端为94.9%。结论：放大内镜可评价绒毛萎缩，并可用于GVHD的光学活检。
Aim: To measure histological villous atrophy and to clarify the diagnostic accuracy of endoscopic villous atrophy in gastrointestinal graft-versus-host disease. Methods: Data for patients who underwent upper and/or lower endoscopic examinations after hematopoietic stem cell transplantation were retrospectively collected. In study 1, group A included 56 patients in whom GI-GVHD was histologically confirmed and group B included 60 patients in whom GI-GVHD was not histologically confirmed. Group C included 59 patients before HSCT. The lengths of villi and crypts in the duodenum and terminal ileum were histologically measured. In study 2, the diagnostic accuracies of villous atrophy of the duodenum and of the terminal ileum using magnifying endoscopy were evaluated. Results: In study 1, the lengths of villi and the villi/crypt (V/C) ratios of the duodenum and terminal ileum in group A were significantly smaller than those in the other groups (p< 0.05). V/C ratio was moderately correlated with clinical severity, histological grades, and endoscopic grades in the terminal ileum. In study 2, the diagnostic accuracies of magnified images for villous atrophy were 83.8% in the duodenum and 94.9% in the terminal ileum. Conclusion: Magnifying endoscopy enables evaluation of villous atrophy and is useful for optical biopsy of GVHD.