Galli Gloria, Purchiaroni Flaminia, Lahner Edith, Sacchi Maria Carlotta, Pilozzi Emanuela, Corleto Vito Domenico, Di Giulio Emilio, Annibale Bruno
Medical-Surgical Department of Clinical Sciences and Translational Medicine, Sant'Andrea Hospital, School of Medicine, University Sapienza, Rome, Italy.
Clinical Molecular Medicine Department, Sant'Andrea Hospital, School of Medicine, University Sapienza, Rome, Italy.
United European Gastroenterol J. 2017 Oct;5(6):811-818. doi: 10.1177/2050640616680971. Epub 2016 Nov 16.
Duodenal intraepithelial lymphocytosis (DIL) is a histological finding characterized by the increase of intraepithelial CD3T-lymphocytes over the normal value without villous atrophy, mostly associated to coeliac disease (CD), (Hp) gastritis and autoimmune diseases.
To assess the occurrence of DIL, CD and Hp gastritis in an endoscopic population over a 13 year period.
From 2003 to 2015 we included adult patients who consecutively underwent oesophago-gastro-duodenoscopy (OGD) with duodenal biopsies assessing the overall and annual occurrence of DIL and CD and the prevalence of Hp gastritis.
160 (2.3%) patients with DIL and 275 (3.9%) with CD were detected among 7001 patients. CD occurrence was higher from 2003 to 2011, while since 2012 DIL occurrence gradually increased significantly compared to CD ( = 0.03). DIL patients were more frequently female ( = 0.0006) and underwent OGD more frequently for dyspepsia ( = 0.002) and for indications not related to gastrointestinal symptoms than CD patients ( = 0.0003). Hp gastritis occurred similarly in CD and DIL patients but the latter had higher frequency of atrophic body gastritis ( = 0.005).
DIL is a condition increasing in the general endoscopic population mainly diagnosed by chance. Concomitant gastric histological evaluation is able in one third of DIL patients to identify associated possible causes of DIL, such as Hp and atrophic gastritis.
十二指肠上皮内淋巴细胞增多症（DIL）是一种组织学表现，其特征为上皮内CD3 T淋巴细胞数量超过正常值，且无绒毛萎缩，主要与乳糜泻（CD）、幽门螺杆菌（Hp）胃炎及自身免疫性疾病相关。
评估13年间内镜检查人群中DIL、CD及Hp胃炎的发生率。
2003年至2015年，我们纳入了连续接受食管-胃-十二指肠镜检查（OGD）及十二指肠活检的成年患者，以评估DIL和CD的总体及年度发生率以及Hp胃炎的患病率。
在7001例患者中，检测到160例（2.3%）患有DIL，275例（3.9%）患有CD。2003年至2011年CD的发生率较高，而自2012年起，与CD相比，DIL的发生率显著逐渐增加（P = 0.03）。DIL患者女性更为常见（P = 0.0006），因消化不良接受OGD检查的频率更高（P = 0.002），且与CD患者相比，因非胃肠道症状相关指征接受OGD检查的频率更高（P = 0.0003）。CD和DIL患者中Hp胃炎的发生率相似，但后者萎缩性胃体炎的发生率更高（P = 0.005）。
DIL在普通内镜检查人群中呈增加趋势，主要为偶然诊断。在三分之一的DIL患者中，同时进行的胃部组织学评估能够识别出DIL的相关可能病因，如Hp和萎缩性胃炎。
