Münster M, Vieth M, Hörauf A
Dr. Michael Münster, Tierärztliche Gemeinschaftspraxis Dr. Hörauf und Dr. Münster, Hatzfeldstraße 6, 51069 Köln, Germany, Email:
Tierarztl Prax Ausg K Kleintiere Heimtiere. 2013;41(6):375-82.
An important premise for obtaining diagnostically relevant histology specimens is an appropriate biopsy technique. Goal of this study was to determine if biopsies of adequate quality can be obtained from the canine esophagus at the gastro-esophageal junction (GEJ) during routine upper gastrointestinal endoscopy.
Over the course of one year, 58 dogs undergoing upper gastrointestinal endoscopy because of the presence of esophageal (n = 22) or gastrointestinal (n = 36) clinical signs were prospectively included. Five biopsies were repeatedly collected from the same dorsal and ventral locations of the GEJ, fixated individually in 4% neutral buffered formaldehyde, and evaluated histopathologically after standard preparation and haematoxylin and eosin staining. The presence of esophageal squamous epithelium with a basal cell layer and lamina propria mucosae in conjunction with foveolar columnar epithelium and cardiac glands, and the absence of fundic glands in one specimen, respectively, was judged as an adequately sampled biopsy.
Adequately sampled biopsies were reported in 45 out of 58 dogs, with 31 samples originating from the dorsal GEJ, 36 samples originating from the ventral GEJ, and with 22 samples originating from both sites, respectively. The incidence of adequately sampled biopsies increased significantly over time (r = 0,22; p < 0,05), with these biopsies being reported significantly more often during the last 6 months compared to the first 6 months of the study (p = 0,03). Histopathological evaluation of the esophageal squamous epithelium showed fibrosis, inflammation, elongation of the stromal papillae, and increased thickness of the basal cell layers in 14 out of 58 dogs. Stromal papillae of the ventral esophageal epithelium were significantly elongated in dogs with esophageal clinical signs compared to dogs with gastrointestinal clinical signs (p = 0,03).
After an initial learning phase adequate esophageal biopsies from the GEJ can be obtained in canine patients undergoing upper gastrointestinal endoscopy, and histological lesions can be found in these biopsies.
获取具有诊断意义的组织学标本的一个重要前提是采用合适的活检技术。本研究的目的是确定在常规上消化道内镜检查期间,能否从犬食管胃食管交界处(GEJ)获取质量足够的活检标本。
在一年的时间里,前瞻性纳入了58只因食管(n = 22)或胃肠道(n = 36)临床症状而接受上消化道内镜检查的犬。从GEJ相同的背侧和腹侧位置重复采集5块活检组织,分别固定于4%中性缓冲甲醛中,经标准制片及苏木精-伊红染色后进行组织病理学评估。在一个标本中,同时存在具有基底细胞层和黏膜固有层的食管鳞状上皮以及小凹柱状上皮和贲门腺,且无胃底腺,被判定为活检取材充分。
58只犬中有45只报告活检取材充分,其中31份标本来自GEJ背侧,36份标本来自GEJ腹侧,22份标本来自两个部位。取材充分的活检标本的发生率随时间显著增加(r = 0.22;p < 0.05),与研究的前6个月相比,在最后6个月报告的此类活检标本明显更多(p = 0.03)。58只犬中有14只的食管鳞状上皮组织病理学评估显示有纤维化、炎症、基质乳头延长和基底细胞层增厚。与有胃肠道临床症状的犬相比,有食管临床症状的犬腹侧食管上皮的基质乳头明显延长(p = 0.03)。
经过初始学习阶段后,对上消化道内镜检查的犬患者,可从GEJ获取足够的食管活检标本,并能在这些活检标本中发现组织学病变。