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Histological and magnified endoscopic evaluation of villous atrophy in gastrointestinal graft-versus-host disease

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Abstract

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.

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Abbreviations

GVHD:

Graft-versus-host disease

HSCT:

Hematopoietic stem cell transplantation

GI:

Gastrointestinal

V/C:

Villi/crypt

EGD:

Esophagogastroduodenoscopy

CS:

Colonoscopy

RRT:

Regimen-related toxicity

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Acknowledgments

The authors thank the pathologists at Department of Surgical Pathology for providing pathological diagnosis of GI-GVHD.

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Authors and Affiliations

  1. Department of Gastroenterology and Hepatology, Hokkaido University Faculty of Medicine, Nishi-7, Kita-15, Kita-ku, Sapporo, 060-8638, Japan

    Kana Matsuda, Ikko Tanaka, Masaki Inoue, Sayoko Kinowaki, Marin Ishikawa, Momoko Tsuda & Naoya Sakamoto

  2. Division of Endoscopy, Hokkaido University Hospital, Nishi-7, Kita-15, Kita-ku, Sapporo, 060-8638, Japan

    Shoko Ono, Keiko Yamamoto & Yuichi Shimizu

  3. Department of Hematology, Hokkaido University Faculty of Medicine, Nishi-7, Kita-15, Kita-ku, Sapporo, 060-8638, Japan

    Shuichiro Takahashi, Daigo Hashimoto & Takanori Teshima

  4. Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Eiko Hayase

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  1. Kana Matsuda
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  2. Shoko Ono
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  3. Ikko Tanaka
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Corresponding author

Correspondence to Shoko Ono.

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The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This study was approved by the Hokkaido University Hospital Review Board (016–0467).

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Informed consent was obtained from all individual participants included in the study.

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Matsuda, K., Ono, S., Tanaka, I. et al. Histological and magnified endoscopic evaluation of villous atrophy in gastrointestinal graft-versus-host disease. Ann Hematol 99, 1121–1128 (2020). https://doi.org/10.1007/s00277-020-03966-y

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  • DOI: https://doi.org/10.1007/s00277-020-03966-y

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