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논문 기본 정보

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저자정보
Prasenjit Das (All India Institute of Medical Sciences) Gaurav PS Gahlot (All India Institute of Medical Sciences) Alka Singh (All India Institute of Medical Sciences) Vandana Baloda (All India Institute of Medical Sciences) Ramakant Rawat (All India Institute of Medical Sciences) Anil K Verma (All India Institute of Medical Sciences) Gaurav Khanna (All India Institute of Medical Sciences) Maitrayee Roy (All India Institute of Medical Sciences) Archana George (All India Institute of Medical Sciences) Ashok Singh (All India Institute of Medical Sciences) Aasma Nalwa (All India Institute of Medical Sciences) Prashant Ramteke (All India Institute of Medical Sciences) Rajni Yadav (All India Institute of Medical Sciences) Vineet Ahuja (All India Institute of Medical Sciences) Vishnubhatla Sreenivas (All India Institute of Medical Sciences) Siddhartha Datta Gupta (All India Institute of Medical Sciences) Govind K Makharia (All India Institute of Medical Sciences)
저널정보
대한장연구학회 Intestinal research Intestinal research Vol.17 No.3
발행연도
2019.1
수록면
387 - 397 (11page)

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Background/Aims: The existing histological classifications for the interpretation of small intestinal biopsies are based on qualitative parameters with high intraobserver and interobserver variations. We have developed and propose a quantitative histological classification system for the assessment of intestinal mucosal biopsies. Methods: We performed a computer-assisted quantitative histological assessment of digital images of duodenal biopsies from 137 controls and 124 patients with celiac disease (CeD) (derivation cohort). From the receiver-operating curve analysis, followed by multivariate and logistic regression analyses, we identified parameters for differentiating control biopsies from those of the patients with CeD. We repeated the quantitative histological analysis in a validation cohort (105 controls and 120 patients with CeD). On the basis of the results, we propose a quantitative histological classification system. The new classification was compared with the existing histological classifications for interobserver and intraobserver agreements by a group of qualified pathologists. Results: Among the histological parameters, intraepithelial lymphocyte count of ≥25/100 epithelial cells, adjusted villous height fold change of ≤0.7, and crypt depth-to-villous height ratio of ≥0.5 showed good discriminative power between the mucosal biopsies from the patients with CeD and those from the controls, with 90.3% sensitivity, 93.5% specificity, and 96.2% area under the curve. Among the existing histological classifications, our quantitative histological classification showed the highest intraobserver (69.7%–85.03%) and interobserver (24.6%–71.5%) agreements. Conclusions: Quantitative assessment increases the reliability of the histological assessment of mucosal biopsies in patients with CeD. Such a classification system may be used for clinical trials in patients with CeD.
#Celiac disease #Intestine #small #Morphometry #Image analysis #Histology #quantitative

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참고문헌 (33)

참고문헌 신청
Oberhuber G / 1999 / The histopathology of coeliac disease : time for a standardized report scheme for pathologists / Eur J Gastroenterol Hepatol 11:1185~1194 google schola Marsh MN / 1992 / Gluten, major histocompatibility complex, and the small intestine. A molecular and immunobiologic approach to the spectrum of gluten sensitivity (‘celiac sprue’) / Gastroenterology 102:330~354 google schola 1990 / Revised criteria for diagnosis of coeliac disease. Report of Working Group of European Society of Paediatric Gastroenterology and Nutrition / Arch Dis Child 65:909~911 google schola Madan M / 2015 / Celiac disease: an assessment of subjective variation and diagnostic reproducibility of the various classification systems / Glob J Med Res 15(1-C):882 google schola Corazza GR / 2007 / Comparison of the interobserver reproducibility with different histologic criteria used in celiac disease / Clin Gastroenterol Hepatol 5:838~843 google schola

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