Do General Pathologists Assess Gastric and Duodenal Eosinophilia?

IF 3.7 3区 医学 Q2 MEDICAL LABORATORY TECHNOLOGY Archives of pathology & laboratory medicine Pub Date : 2023-09-01 DOI:10.5858/arpa.2022-0204-OA
A Joe Saad, Robert M Genta, Kevin O Turner, Amol P Kamboj, Evan S Dellon, Mirna Chehade
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引用次数: 2

Abstract

Context.—: Eosinophilic diseases of the gastrointestinal tract (EGIDs), eosinophilic gastritis (EoG), and eosinophilic duodenitis (EoD) are rarely suspected clinically and infrequently detected by pathologists.

Objective.—: To determine whether histories of allergic or eosinophilic disorders and requests to rule out EoG and EoD affect pathologists' awareness of eosinophils in gastrointestinal biopsies.

Design.—: Thirty-one community-based pathologists were given 16 sets of biopsies from gastric and duodenal mucosa with elevated eosinophils, Helicobacter pylori gastritis, atrophic gastritis, normal stomach and duodenum, lymphocytosis, and celiac disease. Participants were assigned to 3 groups: group A did not receive histories of allergic or eosinophilic conditions; group B received similar histories plus a clue of possible allergic or eosinophilic conditions; and group C received the same histories as B and was asked to rule out EoG/EoD. A list of gastric and duodenal diagnoses and a space for comments were provided. Results were analyzed descriptively.

Results.—: Pathologists correctly diagnosed most noneosinophilic gastrointestinal disorders, indicating competence in gastrointestinal pathology. With respect to EoG and EoD, pathologists in group C performed significantly better that those in groups A and B. The combined odds ratio with 95% CI was 12.34 (2.87-53.04), P < .001, for A versus C and 4.02 (1.60-10.09), P < .02, for B versus C.

Conclusions.—: Most pathologists neither reported gastric/duodenal eosinophilia nor diagnosed EoG/EoD, even when provided histories of eosinophilic disorders. Requests to rule out EoG/EoD resulted in only 4 of 11 participants evaluating and counting eosinophils in some cases. Simple evidence-based histopathologic criteria are needed before pathologists can be expected to consider and diagnose EGIDs.

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普通病理学家评估胃和十二指肠嗜酸性粒细胞增多吗?
上下文。-:胃肠道嗜酸性疾病(EGIDs)、嗜酸性胃炎(EoG)和嗜酸性十二指肠炎(EoD)在临床上很少被怀疑,病理学家也很少发现。目的:确定过敏史或嗜酸性粒细胞疾病史以及排除EoG和EoD的要求是否会影响病理学家在胃肠道活检中对嗜酸性粒细胞的认识。-: 31名社区病理学家对嗜酸性粒细胞升高、幽门螺杆菌胃炎、萎缩性胃炎、正常胃和十二指肠、淋巴细胞增多症和乳糜泻的胃和十二指肠粘膜进行了16组活检。参与者被分为3组:A组没有过敏或嗜酸性粒细胞病史;B组患者有相似的病史,并可能有过敏或嗜酸性粒细胞增多的情况;C组接受与B组相同的病史,并被要求排除EoG/EoD。提供了胃和十二指肠诊断的清单和评论空间。结果进行描述性分析。-:病理学家正确诊断了大多数非嗜酸性胃肠道疾病,表明了他们在胃肠道病理学方面的能力。在EoG和EoD方面,C组病理医师的表现明显优于A、B组。A组与C组的合并优势比(95% CI)为12.34 (2.87 ~ 53.04),P < 0.001; B组与C组的合并优势比(95% CI)为4.02 (1.60 ~ 10.09),P < 0.02。大多数病理学家既没有报告胃/十二指肠嗜酸性粒细胞增多症,也没有诊断出EoG/EoD,即使提供了嗜酸性粒细胞增多症的病史。在某些情况下,要求排除EoG/EoD导致11名参与者中只有4人评估和计数嗜酸性粒细胞。在病理学家考虑和诊断EGIDs之前,需要简单的循证组织病理学标准。
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来源期刊
CiteScore
9.20
自引率
2.20%
发文量
369
审稿时长
3-8 weeks
期刊介绍: Welcome to the website of the Archives of Pathology & Laboratory Medicine (APLM). This monthly, peer-reviewed journal of the College of American Pathologists offers global reach and highest measured readership among pathology journals. Published since 1926, ARCHIVES was voted in 2009 the only pathology journal among the top 100 most influential journals of the past 100 years by the BioMedical and Life Sciences Division of the Special Libraries Association. Online access to the full-text and PDF files of APLM articles is free.
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