Quantitative histology as a diagnostic tool for celiac disease in children and adolescents |
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| Affiliation: | 1. Pediatric and Pediatric Surgery Department, State University of Londrina, Londrina, Paraná, Brazil;2. Department of Pathology, Federal University of Sao Paulo, Sao Paulo, Sao Paulo, Brazil;3. Departament of Pediatric Gastroenterology, Federal University of Sao Paulo, Sao Paulo, Sao Paulo, Brazil;1. Department of Pathology, Beijing Tongren Hospital, Capital Medical University, Beijing Key Laboratory of Head and Neck Molecular Diagnostic Pathology, Beijing 100730, China;2. Department of Pathology, Beijing Chuiyangliu Hospital, Beijing 100022, China;1. Department of Diagnostic Pathology, Shizuoka Cancer Center, Shizuoka, Japan;2. Department of Hepatobiliary-Pancreatic Surgery, Shizuoka Cancer Center, Shizuoka, Japan;3. Department of Diagnostic Pathology, Fukui Prefecture Saiseikai Hospital, Fukui, Japan;4. Department of Surgery, School of Medicine, Nihon University, Tokyo, Japan;5. Department of Internal Medicine, Fukui Prefecture Saiseikai Hospital, Fukui, Japan;6. Department of Digestive Surgery, Fukui Prefecture Saiseikai Hospital, Fukui, Japan;7. Department of Human Pathology, Juntendo University School of Medicine, Tokyo, Japan;8. Department of Digestive Internal Medicine, Shizuoka Medical Center, Shizuoka, Japan;9. Department of Human Pathology, Kanazawa University School of Medicine, Kanazawa, Japan;1. Department of Pathology, Medical College of Wisconsin, Milwaukee, WI, USA;2. Otolaryngology-Head and Neck Surgery, Medical College of Wisconsin, Milwaukee, WI, USA;3. Institute of Medical and Public Health Research, Ilia State University, Tbilisi, Georgia;1. Department of Thoracic Surgery, Sun Yat-sen University Cancer Center, Guangzhou, China;2. State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center (SYSUCC), Guanghzou, China;3. Department of Minimally Invasive Interventional Therapy, Sun Yat-sen University Cancer Center, Guangzhou, China |
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| Abstract: | ObjectiveTo measure the villous height, the crypt depth, and the number of intraepithelial lymphocytes/100 enterocytes of the small intestinal mucosa of children and adolescents with celiac disease; and to classify these findings according to Q- Marsh and Q-histology scales.MethodsRetrospective study of a database from the Department of Pathology of biopsies from the second portion of the duodenum of pediatric patients. According to the histological report, three groups were established: celiac disease at diagnosis (n = 50), controls (n = 26), giardiasis (n = 10). In each biopsy, software (cellSens and Image J) evaluated 5 villous heights, 5 crypt depth and the number of intraepithelial lymphocytes/100 enterocytes.ResultsThe celiac group had the lowest mean villous height (197.83 μm) of all three groups (control = 477.70 μm; giardiasis = 397.04 μm. The celiac group's villous:crypt ratio (0.78) was significantly lower than the control group (1.89). The number of intraepithelial lymphocytes ≥25 was exclusive to the celiac group, with a sensitivity and specificity of 100 %. Only celiac patients were included in types 2 and 3 of the Q-histology classification.ConclusionCeliac disease patients showed shorter villous height than other groups, and the number of intraepithelial lymphocytes ≥25 was the best parameter to differentiate celiac from controls and giardiasis groups. Intraepithelial lymphocytes ≥25/100 enterocytes associated with any degree of villous atrophy, the classic Marsh 3 type, set the histological parameters of celiac disease. Quantitative histology is a valuable tool for diagnosing celiac disease, enabling histological changes in a short time, and the Q-histology scale appears to be more suitable than the Q-Marsh scale. |
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