[Recto-colic graft-versus-host disease (GVH). Diagnostic and prognostic criteria in a cohort of patients from Amiens university hospital].

IF 0.5 4区 医学 Q4 PATHOLOGY Annales De Pathologie Pub Date : 2024-09-05 DOI:10.1016/j.annpat.2024.08.003
Benjamin Ducloux-Lebon, Delphine Lebon, Jean-René Tesson, Mathurin Fumery, Jean-Pierre Marolleau, Denis Chatelain
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Abstract

Introduction: Recto-colic graft-versus-host disease (GVHD) is a frequent and serious complication of hematopoietic stem cell allogeneic transplantation, which is sometimes difficult to diagnose. The aim of our study was to identify histological diagnostic and prognostic criteria for recto-colic GVH.

Material and method: Patients allografted at Amiens university hospital from 2012 to 2017 were retrieved. Those who had a recto-colic biopsy were included and divided into two groups (final diagnosis of GVH and non-GVH), then biopsies were reviewed by 2 pathologists.

Results: One hundred and nineteen patients were included. Sixty-seven were allocated to the GVH group and 52 to the non-GVH group. In the GVH group, we observed a significantly greater number of apoptotic bodies (AB) on standard HES staining and with the anti-Caspase 3 immunohistochemistry, cryptolytic AB abscesses, atrophy, regenerative glands and glands lined with eosinophilic cells (P<0.001). Anti-Caspase 3 immunohistochemistry revealed more AB than standard HES staining (P<0.005). But to differentiate GVH cases from non-GVH cases, we obtained a threshold value of 3.5 AB per 10 contiguous crypts on standard HE staining and with the anti-Caspase 3 immunohistochemistry. From 4 AB per 10 contiguous crypts, on HES staining and anti-Caspase 3 immunostaining, the diagnosis of GVH became consistent. No non-GVH case had more than 6 AB per 10 contiguous crypts. GVH patients with more than 8 AB per 10 contiguous crypts had a worse prognosis (P<0.001).

Conclusion: We confirm the value of AB and their counting in the diagnosis of GVH, with a diagnostic threshold of 4 AB and a prognostic threshold of 8 AB. Glands lined with eosinophilic cells could be an additional diagnostic criterion in favor of GVH to be confirmed by further studies.

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[直肠结肠移植物抗宿主病(GVH)。亚眠大学医院一组患者的诊断和预后标准]。
简介直肠结肠移植物抗宿主病(GVHD)是造血干细胞异基因移植中一种常见的严重并发症,有时很难诊断。我们的研究旨在确定直肠结肠移植物抗宿主病的组织学诊断和预后标准:检索2012年至2017年亚眠大学医院的异体移植患者。将进行直肠结肠活检的患者纳入其中,并分为两组(最终诊断为GVH和非GVH),然后由两名病理学家对活检结果进行审查:结果:共纳入 119 名患者。结果:共纳入 119 例患者,其中 67 例被分配到 GVH 组,52 例被分配到非 GVH 组。在 GVH 组中,我们观察到标准 HES 染色法和抗 Caspase 3 免疫组化法检测到的凋亡体(AB)数量明显增多,还观察到隐溶性 AB 脓肿、萎缩、再生腺体和内衬嗜酸性细胞的腺体(PC):我们确认了 AB 及其计数在 GVH 诊断中的价值,诊断阈值为 4 AB,预后阈值为 8 AB。嗜酸性细胞衬里的腺体可能是有利于 GVH 的额外诊断标准,有待进一步研究证实。
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来源期刊
Annales De Pathologie
Annales De Pathologie 医学-病理学
CiteScore
0.40
自引率
20.00%
发文量
111
审稿时长
6-12 weeks
期刊介绍: Les Annales de pathologie vous permettent d''enrichir vos connaissances et de découvrir les évolutions des recherches au travers d''articles originaux, de mises au point, de cas anatomo-cliniques et de lettres à la rédaction rédigés par les meilleurs spécialistes. Les Annales de pathologie vous proposent de nombreuses illustrations couleur de qualité, qui améliorent la compréhension des articles et renforcent vos compétences diagnostiques. Les Annales de pathologie sont le lieu de rencontre privilégié de la discipline, où sont publiés des comptes-rendus de journées scientifiques, les informations concernant les EPU et les fonds de recherche et des annonces de réunions diverses.
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