Background and Aims

In children with eosinophilic oesophagitis (EoE), the relationship among Endoscopic Reference Score (EREFS), Histology Scoring System (EoEHSS), and peak eosinophil count (PEC) is incompletely described. Our aim was to determine the relationship among EREFS, EoEHSS, and PEC, and develop a predictive model using components of EREFS and EoEHSS for EoE activity.

Methods

We analyzed 189 paired EREFS, EoEHSS, and PEC. Active EoE (aEoE; n=98) was defined as ≥15 eos/hpf, and inactive EoE (iEoE; n=91) as <15 eos/hpf. Spearman correlation (r) with Bonferroni correction was used to assess the relationship between EREFS, EoEHSS and PEC, and a back-transformed average Fisher test to determine the statistical significance of the differences. Reciever operating characteristic analysis was used to develop the predictive model.

Results

The relationship between total EREFS and EoEHSS was modest (r= 0.61) but significantly stronger than the correlation between total EREFS and PEC (r=0.55; P=0.04). The relationship between total EREFS and EoEHSS tended to be stronger in aEoE compared with iEoE (r: 0.41 vs 0.24; P=0.09). Compared with EREFS, EoEHSS had a significantly higher area under the curve (AUC, 0.78 vs 0.92; P=0.04) to predict aEoE. A combination of furrows, eosinophilic inflammation, basal cell hyperplasia, eosinophilic abscess, and dilated intercellular spaces had an AUC of 0.97, accuracy of 98%, sensitivity of 97% and specificity of 98% to predict aEoE.

Conclusions

Endoscopy score modestly correlates with histologic scoring system. As such, endoscopy score is not a reliable marker of tissue involvement in EoE. A panel of individual endoscopic and histologic signs hold promise to accurately predict EoE activity.

中文翻译：

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嗜酸性粒细胞性食管炎患儿的内窥镜征象与黏膜改变的相关性。

背景和目标

对于患有嗜酸性粒细胞性食管炎（EoE）的儿童，内窥镜参考评分（EREFS），组织学评分系统（EoEHSS）和峰值嗜酸性粒细胞计数（PEC）之间的关系不完整。我们的目的是确定EREFS，EoEHSS和PEC之间的关系，并使用EREFS和EoEHSS的成分开发EoE活性的预测模型。

方法

我们分析了189对EREFS，EoEHSS和PEC。有效EoE（aEoE; n = 98）定义为≥15 eos / hpf，不活动EoE（iEoE; n = 91）定义为<15 eos / hpf。使用Spearman相关（r）和Bonferroni校正来评估EREFS，EoEHSS和PEC之间的关系，并使用反变换的平均Fisher检验确定差异的统计显着性。接收器运行特性分析用于建立预测模型。

结果

总EREFS和EoEHSS之间的关系适度（r = 0.61），但比总EREFS和PEC之间的相关性更强（r = 0.55; P = 0.04）。与iEoE相比，aEoE中的总EREFS和EoEHSS之间的关系趋于增强（r：0.41对0.24； P = 0.09）。与EREFS相比，EoEHSS的曲线下面积显着更高（AUC，0.78对0.92； P = 0.04），可以预测aEoE。犁沟，嗜酸性粒细胞炎症，基底细胞增生，嗜酸性脓肿和扩张的细胞间隙的组合具有0.97的AUC，98％的准确性，97％的敏感性和98％的预测aEoE的特异性。

结论

内窥镜评分与组织学评分系统之间存在适度的相关性。因此，内窥镜评分不是组织参与EoE的可靠标志。一组单独的内窥镜和组织学体征有望准确预测EoE活性。