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.
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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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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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