颞动脉活检中孤立性外膜和外膜周围浸润对巨细胞动脉炎诊断的预测价值较低。
Poor Predictive Value of Isolated Adventitial and Periadventitial Infiltrates in Temporal Artery Biopsies for Diagnosis of Giant Cell Arteritis.
作者信息
Le Pendu Claire, Meignin Véronique, Gonzalez-Chiappe Solange, Hij Adrian, Galateau-Sallé Françoise, Mahr Alfred
机构信息
From the Department of Internal Medicine, Unit for Systemic Diseases (UF07), and Department of Pathology, and Department of Internal Medicine, Unit for Autoimmune and Vascular Diseases (UF04), Saint-Louis University Hospital; ECSTRA Team, Epidemiology and Biostatistics, Sorbonne Paris Cité Research Center UMR 1153, INSERM, Paris; Department of Pathology, University Hospital Caen, Caen; Department of Biopathology, Léon-Bérard Cancer Center, Lyon, France.
C. Le Pendu, MD, Department of Internal Medicine, Unit for Systemic Diseases (UF07), Saint-Louis University Hospital; V. Meignin, MD, Department of Pathology, Saint-Louis University Hospital; S. Gonzalez-Chiappe, MD, MPH, Department of Internal Medicine, Unit for Systemic Diseases (UF07), Saint-Louis University Hospital; A. Hij, MD, Department of Internal Medicine, Unit for Autoimmune and Vascular Diseases (UF04), Saint-Louis University Hospital; F. Galateau-Sallé, MD, PhD, Department of Pathology, University Hospital Caen, and Department of Biopathology, Léon-Bérard Cancer Center; A. Mahr, MD, MPH, PhD, Department of Internal Medicine, Unit for Systemic Diseases (UF07), Saint-Louis University Hospital, and ECSTRA Team, Epidemiology and Biostatistics, Sorbonne Paris Cité Research Center UMR 1153, INSERM.
出版信息
J Rheumatol. 2017 Jul;44(7):1039-1043. doi: 10.3899/jrheum.170061. Epub 2017 May 1.
OBJECTIVE
We investigated the diagnostic value of inflammation limited to the adventitia (ILA), and isolated vasa vasorum or small-vessel vasculitis (VVV, SVV) in temporal artery biopsies (TAB) for giant cell arteritis (GCA).
METHODS
Two pathologists reviewed consecutive first TAB. Using the clinical diagnoses as the gold standard, positive predictive values (PPV) were calculated.
RESULTS
Among the 75 patients without classic TAB features of GCA, 8 had GCA diagnoses. The PPV of ILA, VVV, and SVV seen by either or both pathologists were 17%, 0%, and 7%, and 17%, 0%, and 10%, respectively.
CONCLUSION
(Peri)adventitial infiltrates in TAB poorly predict GCA.
目的
我们研究了颞动脉活检（TAB）中仅局限于外膜的炎症（ILA）、孤立的滋养血管或小血管血管炎（VVV、SVV）对巨细胞动脉炎（GCA）的诊断价值。
方法
两名病理学家回顾了连续的首次TAB。以临床诊断作为金标准，计算阳性预测值（PPV）。
结果
在75例无GCA典型TAB特征的患者中，8例被诊断为GCA。两名病理学家中任何一人或两人观察到的ILA、VVV和SVV的PPV分别为17%、0%和7%，以及17%、0%和10%。
结论
TAB中的（外膜周围）外膜浸润对GCA的预测性较差。
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