常规胃和十二指肠活检对嗜酸性食管炎患者有价值吗？来自大型单一中心案件登记处的证据
Do Routine Gastric and Duodenal Biopsies Add Value in Patients with Eosinophilic Esophagitis? Evidence from a Large Single-Center Case Registry.
摘要(中文译文)
在疑似嗜酸性粒细胞性食管炎（EoE）时，于指数内镜检查中常规进行胃和十二指肠活检的建议仍存在争议，因为支持证据有限。我们旨在评估一个大型真实世界EoE队列中胃和十二指肠组织病理学的患病率、临床相关性及预测因素。这项回顾性单中心研究纳入了2001年至2024年间诊断为EoE并登记于EoE CONNECT注册库的成人和儿童患者。对诊断时或随访时获得的胃和/或十二指肠活检进行了审查。组织学发现被分类为特定诊断类别，并根据临床表现、内镜特征和年龄组进行分析。我们评估了340例患者（35.7%为儿童），其中88.5%接受了胃和十二指肠活检。食管外发现的总体诊断率为20.9%，主要为幽门螺杆菌相关胃炎（18.8%），但具有临床意义的诊断如乳糜泻（0.6%）和嗜酸性粒细胞性胃炎（0.3%）的诊断率极低。症状和内镜异常与病理发现无显著关联（p=0.11）。此外，年龄分层分析显示特定诊断无显著差异，尽管食管外活检病理阳性的患者年龄显著更大（p<0.001）。随访活检显示大多数病理发现在初次诊断后消退，其中幽门螺杆菌相关胃炎占消退病例的大多数。在EoE患者背景下，常规食管外活检的诊断率低，且很少改变临床管理，无论年龄如何。因此，我们的研究结果主张对EoE患者的食管外取样采取选择性而非普遍性策略。
Abstract
The recommendation of routine gastric and duodenal biopsies at index endoscopy on suspicion of eosinophilic esophagitis (EoE) remains controversial because of the limited supporting evidence. We aimed to evaluate the prevalence, clinical relevance, and predictors of gastric and duodenal histopathology in a large real-world EoE cohort. This retrospective single-center study included adult and pediatric patients with EoE diagnosed between 2001 and 2024 and enrolled in the EoE CONNECT registry. Gastric and/or duodenal biopsies obtained at diagnosis or follow-up were reviewed. Histologic findings were classified into specific diagnostic categories and analyzed according to clinical presentation, endoscopic features, and age group. We evaluated 340 patients (35.7% children), of whom 88.5% underwent both gastric and duodenal biopsies. The overall diagnostic yield for extra-esophageal findings was 20.9%, predominantly -associated gastritis (18.8%), but with a very low yield of clinically meaningful diagnoses such as celiac disease (0.6%) and eosinophilic gastritis (0.3%). Symptoms and endoscopic abnormalities were not significantly associated with pathological findings (p=0.11). Moreover, age-stratified analysis revealed no significant differences in specific diagnoses, although patients with pathological extra-esophageal biopsies were significantly older (p<0.001). Follow-up biopsies demonstrated resolution of most pathological findings after the initial diagnosis, with -associated gastritis accounting for the majority of cases that resolved. Routine extra-esophageal biopsies in the context of patients with EoE have a low diagnostic yield and rarely alter clinical management, regardless of age. Therefore, our findings advocate for a selective rather than universal approach to extra-esophageal sampling in patients with EoE.
如何引用
AMA
Elena Grueso-Navarro, Victoria Úbeda-Vargas, Rocío Juárez-Tosina, Laura Arias-González, Emilio J Laserna-Mendieta, Alfredo J Lucendo. Do Routine Gastric and Duodenal Biopsies Add Value in Patients with Eosinophilic Esophagitis? Evidence from a Large Single-Center Case Registry.. Diagnostics (Basel, Switzerland). 2026; doi:10.3390/diagnostics16101446.
APA
Elena Grueso-Navarro, Victoria Úbeda-Vargas, Rocío Juárez-Tosina, Laura Arias-González, Emilio J Laserna-Mendieta, Alfredo J Lucendo (2026). Do Routine Gastric and Duodenal Biopsies Add Value in Patients with Eosinophilic Esophagitis? Evidence from a Large Single-Center Case Registry.. Diagnostics (Basel, Switzerland). https://doi.org/10.3390/diagnostics16101446
GB/T 7714
Elena Grueso-Navarro, Victoria Úbeda-Vargas, Rocío Juárez-Tosina, Laura Arias-González, Emilio J Laserna-Mendieta, Alfredo J Lucendo. Do Routine Gastric and Duodenal Biopsies Add Value in Patients with Eosinophilic Esophagitis? Evidence from a Large Single-Center Case Registry.[J]. Diagnostics (Basel, Switzerland), 2026 doi:10.3390/diagnostics16101446.
在 PubMed增强版 阅读全文
翻译全文 · AI 文献问答 · PDF 原文下载 · 引用导出