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Histological and magnified endoscopic evaluation of villous atrophy in gastrointestinal graft-versus-host disease.
Annals of Hematology ( IF 3.5 ) Pub Date : 2020-03-04 , DOI: 10.1007/s00277-020-03966-y
Kana Matsuda 1 , Shoko Ono 2 , Ikko Tanaka 1 , Masaki Inoue 1 , Sayoko Kinowaki 1 , Marin Ishikawa 1 , Momoko Tsuda 1 , Keiko Yamamoto 2 , Yuichi Shimizu 2 , Shuichiro Takahashi 3 , Eiko Hayase 4 , Daigo Hashimoto 3 , Takanori Teshima 3 , Naoya Sakamoto 1
Affiliation  

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.

中文翻译:

胃肠移植物抗宿主病中绒毛萎缩的组织学和内镜放大评估。

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。方法回顾性收集造血干细胞移植后接受内镜和/或内镜检查的患者的数据。在研究1中,A组包括56例在组织学上已确认GI-GVHD的患者,B组包括60例在组织学上未确认GI-GVHD的患者。C组包括59例HSCT之前的患者。组织学测量十二指肠和回肠末端的绒毛和隐窝的长度。在研究2中,使用放大内窥镜评估了十二指肠和回肠末端绒毛萎缩的诊断准确性。结果在研究1中,A组的绒毛长度和十二指肠和回肠末端的绒毛/隐窝(V / C)比均显着小于其他组(p <0.05)。V / C比值与回肠末端的临床严重程度,组织学等级和内窥镜等级相关。在研究2中,十二指肠绒毛萎缩的放大图像的诊断准确性为83.8%,回肠末端为94.9%。结论放大内窥镜检查能够评估绒毛萎缩,并且对GVHD的光学活检有用。十二指肠绒毛萎缩的放大图像的诊断准确性为83.8%,末端回肠为94.9%。结论放大内窥镜检查能够评估绒毛萎缩,并且对GVHD的光学活检有用。十二指肠绒毛萎缩的放大图像的诊断准确性为83.8%,末端回肠为94.9%。结论放大内窥镜检查能够评估绒毛萎缩,并且对GVHD的光学活检有用。
更新日期:2020-03-04
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