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比较慢性小肠肠病犬的十二指肠和回肠内镜活检的组织病理学发现。

Comparison of histopathologic findings in duodenal and ileal endoscopic biopsies in dogs with chronic small intestinal enteropathies.

机构信息

Department of Veterinary Clinical Sciences, The Royal Veterinary College, University of London, North Mymms, UK.

出版信息

J Vet Intern Med. 2013 Mar-Apr;27(2):268-74. doi: 10.1111/jvim.12041. Epub 2013 Feb 9.

Abstract

BACKGROUND

The current tendency when investigating dogs with chronic upper gastrointestinal signs is to perform endoscopy and biopsy only the duodenum. This approach could lead to overlooking important ileal lesions and affect the clinical management.

OBJECTIVES

To compare concurrent duodenal and ileal endoscopic biopsies in dogs with chronic enteropathies and evaluate their correlation with clinicopathologic findings.

ANIMALS

Thirty-eight dogs with chronic enteropathies.

METHODS

Duodenal and ileal biopsies were retrospectively reviewed. Nine histologic variables, 5 structural (villous stunting, epithelial injury, crypt distension, lacteal dilatation, and mucosal fibrosis) and 4 inflammatory (intraepithelial lymphocytes, lamina propria lymphocytes and plasma cells, eosinophils, and neutrophils) were scored. Clinical severity scores and relevant clinicopathologic variables were evaluated.

RESULTS

There was only slight agreement between duodenal and ileal histologic scores (κ = 0.003). There was slight agreement between the presence of any of the morphological and inflammatory variables, with the exception of mucosal fibrosis (κ = 0.44). Statistically significant correlation was found between clinical severity and duodenal crypt distension (P = .031), ileal lacteal dilatation (P = .038), and ileal mucosal lymphoplasmacytic inflammation (P = .035). A significant correlation was found between hypoalbuminemia and ileal lacteal dilatation (P = .033) and number of ileal intraepithelial lymphocytes (P = .019). A statistically significant correlation was found between hypocobalaminemia and number of ileal intraepithelial lymphocytes (P = .012).

CONCLUSIONS AND CLINICAL IMPORTANCE

When investigating dogs with chronic upper gastrointestinal signs, the collection of concurrent duodenal and ileal endoscopic biopsies is recommended.

摘要

背景

当前在研究患有慢性上胃肠道症状的犬时,仅对十二指肠进行内镜检查和活检。这种方法可能会导致忽略重要的回肠病变,并影响临床管理。

目的

比较慢性肠病犬的十二指肠和回肠内镜活检,并评估其与临床病理发现的相关性。

动物

38 只患有慢性肠病的犬。

方法

回顾性分析十二指肠和回肠活检。对 9 种组织学变量(绒毛萎缩、上皮损伤、隐窝扩张、乳糜管扩张、黏膜纤维化)和 4 种炎症(上皮内淋巴细胞、固有层淋巴细胞和浆细胞、嗜酸性粒细胞和中性粒细胞)进行评分。评估临床严重程度评分和相关临床病理变量。

结果

十二指肠和回肠组织学评分之间只有轻微的一致性(κ=0.003)。除了黏膜纤维化(κ=0.44)外,任何形态和炎症变量的存在之间都存在轻微的一致性。临床严重程度与十二指肠隐窝扩张(P=0.031)、回肠乳糜管扩张(P=0.038)和回肠黏膜淋巴浆细胞炎症(P=0.035)之间存在统计学显著相关性。低白蛋白血症与回肠乳糜管扩张(P=0.033)和回肠上皮内淋巴细胞数量(P=0.019)之间存在显著相关性。低钴胺素血症与回肠上皮内淋巴细胞数量(P=0.012)之间存在统计学显著相关性。

结论和临床意义

在研究患有慢性上胃肠道症状的犬时,建议同时采集十二指肠和回肠的内镜活检。

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