食管嗜酸性粒细胞增多症的胞内镜诊断价值。

IF 3 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Digestion Pub Date : 2023-01-01 DOI:10.1159/000528174

Emiko Hida, Koichi Muroi, Naomi Kakushima, Satoshi Furune, Eri Ishikawa, Yasuyuki Mizutani, Tsunaki Sawada, Maeda Keiko, Takeshi Yamamura, Takuya Ishikawa, Kazuhiro Furukawa, Eizaburo Ohno, Masanao Nakamura, Kazuki Nishida, Mitsuhiro Fujishiro, Hiroki Kawashima

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引用次数: 0

摘要

嗜酸性食管炎(EoE)患者食管上皮嗜酸性粒细胞分布不均匀。食管嗜酸性粒细胞增多(EE)可通过内吞镜(EC)观察到。本研究旨在评价EC对情感表达的诊断价值。方法:从2020年3月至2021年4月，共33例EoE患者接受了亚甲基蓝染色的EC。共获得194张EC图像和相应的活检。建立EC的三个表现，鳞状细胞增多(第1项)，炎症细胞增多(第2项)，双叶核细胞增多(第3项)。两位内窥镜医师回顾了这些发现以诊断EE。另外四名内窥镜医生审查了图像，以达成观察者之间的一致。结果:当三项指标均满足时，诊断EE的敏感性为88%，准确率为76%。四名内镜医师诊断EE的综合诊断优势比(OR: 3.98, 95% CI: 2.94 ~ 5.40, p < 0.001)具有统计学意义。只有项目三得到满足时，结果是相似的。第III项诊断EE的观察者间一致性较好(kappa值= 0.653)。讨论/结论:EC对EE的诊断性能是可以接受的，并且具有良好的观察者间一致性。它可能对EoE患者的靶向活检有用。

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Diagnostic Performance of Endocytoscopy for Esophageal Eosinophilia.

Introduction: Eosinophils in the esophageal epithelium are unevenly distributed in eosinophilic esophagitis (EoE). Esophageal eosinophilia (EE) may be observable by endocytoscopy (EC). This study aimed to evaluate the diagnostic performance of EC for the diagnosis of EE.

Methods: A total of 33 EoE patients underwent EC with methylene blue staining from March 2020 to April 2021. A total of 194 EC images with corresponding biopsies were obtained. Three findings of EC, increased squamous cells (item I), increased inflammatory cells (item II), and cells with bilobed nuclei (item III), were established. These findings were reviewed by two endoscopists to diagnose EE. Another four endoscopists reviewed the images for interobserver agreement.

Results: When all three items were met by EC, the sensitivity and the accuracy for the diagnosis of EE were 88% and 76%, respectively. The integrated diagnostic odds ratios (ORs) for the diagnosis of EE of the four endoscopists were significant (OR: 3.98, 95% CI: 2.94-5.40, p < 0.001). The results were similar when only item III was met. Interobserver agreement was good for item III to diagnose EE (kappa value = 0.653).

Discussion/conclusion: The diagnostic performance of EC for EE is acceptable and has good interobserver agreement. It may be useful for targeted biopsy in EoE patients.

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来源期刊

Digestion 医学-胃肠肝病学

CiteScore

7.90

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： ''Digestion'' concentrates on clinical research reports: in addition to editorials and reviews, the journal features sections on Stomach/Esophagus, Bowel, Neuro-Gastroenterology, Liver/Bile, Pancreas, Metabolism/Nutrition and Gastrointestinal Oncology. Papers cover physiology in humans, metabolic studies and clinical work on the etiology, diagnosis, and therapy of human diseases. It is thus especially cut out for gastroenterologists employed in hospitals and outpatient units. Moreover, the journal''s coverage of studies on the metabolism and effects of therapeutic drugs carries considerable value for clinicians and investigators beyond the immediate field of gastroenterology.