乳糜泻的组织病理学。意大利胃肠道病理学家小组(GIPAD-SIAPEC)的立场声明。

IF 1.1 Q4 MEDICINE, RESEARCH & EXPERIMENTAL Translational Medicine at UniSa Pub Date : 2020-10-31 eCollection Date: 2020-10-01
V Villanacci, C Ciacci, T Salviato, G Leoncini, L Reggiani Bonetti, T Ragazzini, F Limarzi, L Saragoni
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引用次数: 0

摘要

乳糜泻(Celiac Disease,CeD)是一种免疫介导的小肠炎症性疾病,暴露于麸质时会影响遗传易感人群。50 多年来,小肠活检一直是乳糜泻 (CeD) 的 "金标准"。尽管如今已经有了敏感而特异的血清学检测方法,但粘膜活检的组织病理学特征在疑似乳糜泻的诊断中仍起着关键作用。这种诊断方法需要一个多学科团队,通过病理学家和胃肠病学家之间的互动,优化组织取样和解释。意大利胃肠道病理学组(GIPAD-SIAPEC)的病理学家与意大利技师协会(AITIC)的一名成员(TR)和一名胃肠病专家(CC)一起提供了立场声明,作为阅读和解释报告的实用工具。此外,还就最近描述的非麸质过敏症(NCGS)制定了立场声明。在这种诊断环境下,十二指肠粘膜的结构异常(即腺体增生和绒毛萎缩)和上皮内 T 淋巴细胞的数量都应得到充分强调。当怀疑有 CeD 或 NCGS 时,抗 CD3 染色等辅助检查有助于准确计数上皮内 T 淋巴细胞。此外,建议对无麸质饮食(GFD)无效的患者进行抗-CD3 和抗-CD8 染色,以确诊难治性乳糜泻(RCeD)。此外,还提供了鉴别诊断乳糜泻和难治性乳糜泻的诊断线索。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Histopathology of Celiac Disease. Position Statements of the Italian Group of Gastrointestinal Pathologists (GIPAD-SIAPEC).

Celiac Disease (CeD) is an immune-mediated inflammatory disorder of the small intestine, affecting genetically susceptible individuals when exposed to gluten. Small intestinal biopsy interpretation has been the "gold standard" for celiac disease (CeD) for over 50 years. Despite today's availability of sensitive and specific serological tests, the histopathological features from mucosal biopsy play a key role in diagnosing when CeD is suspected. Such a diagnostic approach requires a multidisciplinary team to optimize both tissue sampling and interpretation via the interaction between the pathologist and the gastroenterologist. Pathologists of the Italian Group of Gastrointestinal Pathology (GIPAD-SIAPEC), together with a member (TR) of the Italian Society of Technicians (AITIC) and an expert gastroenterologist (CC), provide position statements as a practical tool for reading and interpreting the report. Moreover, a position statement was formulated about the recently described condition known as Non-Celiac Gluten Sensitivity (NCGS). Within such a diagnostic setting, both the architectural abnormalities of the duodenal mucosa, namely glandular hyperplasia, and villous atrophy and the number of intraepithelial T-lymphocytes should be well highlighted. Ancillary tests such as anti-CD3 stain are useful for an accurate count of the intraepithelial T lymphocytes when CeD or NCGS is suspected. Moreover, anti-CD3 and anti-CD8 stains are recommended in patients not responding to the gluten-free diet (GFD) to confirm a diagnosis of Refractory Celiac Disease (RCeD). Diagnostic clues about the differential diagnosis of both CeD and RCeD have also been rendered.

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Translational Medicine at UniSa
Translational Medicine at UniSa MEDICINE, RESEARCH & EXPERIMENTAL-
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