Dawod Hosam M, Emara Mahmoud W
Department of Tropical Medicine, Faculty of Medicine, Zagazig University, Egypt.
Department of Pathology, Zagazig University, Egypt.
Euroasian J Hepatogastroenterol. 2016 Jul-Dec;6(2):97-102. doi: 10.5005/jp-journals-10018-1178. Epub 2016 Dec 1.
Dyspepsia is a common symptom with an extensive differential diagnosis. Endoscopy alone may miss serious mucosal lesions in about 15 to 30% of cases. The aim was to determine histopathological features of gastric and duodenal mucosal biopsies in patients with dyspepsia and normal looking upper gastrointestinal (GI) endoscopy.
One hundred and five adult patients presenting with dyspepsia with no endoscopic mucosal lesions in the upper GI tract were included. Gastric biopsy specimens according to Sydney-Houston system for grading gastritis and biopsy from duodenum were taken. The histopathological features were graded according to the Sydney-Houston system classification for grading gastritis.
The histological lesions were found in 65.7% (69 out of 105 endoscopy free dyspeptic patients). Chronic inflammation was the commonest finding. Neutrophilic activity, glandular atrophy, and mild degree of intestinal metaplasia were present in 27, 45, and 6 patients (22.8, 42.8, and 5.7% respectively). was present in 54 patients with histopathological lesions and in 6 patients without histopathological lesions, and the difference was significant (p = 0.045).
The endoscopic diagnosis of dyspepsia correlated poorly with histopathological findings. The histopathological examination allowed detection and grading of gastric pathology in dyspepsia with normal endoscopy and the commonest finding was the moderate chronic gastritis.
Dawod HM, Emara MW. Histopathological Assessment of Dyspepsia in the Absence of Endoscopic Mucosal Lesions. Euroasian J Hepato-Gastroenterol 2016;6(2):97-102.
消化不良是一种常见症状，鉴别诊断范围广泛。仅靠内镜检查可能会在约15%至30%的病例中漏诊严重的黏膜病变。目的是确定消化不良且上消化道内镜检查外观正常的患者胃和十二指肠黏膜活检的组织病理学特征。
纳入105例有消化不良症状且上消化道内镜检查无黏膜病变的成年患者。根据悉尼-休斯顿胃炎分级系统采集胃活检标本并取自十二指肠。组织病理学特征根据悉尼-休斯顿胃炎分级系统分类进行分级。
在105例内镜检查无病变的消化不良患者中，65.7%（69例）发现了组织学病变。慢性炎症是最常见的发现。27例（22.8%）、45例（42.8%）和6例（5.7%）分别出现中性粒细胞活性、腺体萎缩和轻度肠化生。 在54例有组织病理学病变的患者和6例无组织病理学病变的患者中出现，差异有统计学意义（p = 0.045）。
消化不良的内镜诊断与组织病理学结果相关性较差。组织病理学检查能够在消化不良且内镜检查正常的情况下检测和分级胃部病变，最常见的发现是中度慢性胃炎。
Dawod HM, Emara MW. 无内镜黏膜病变时消化不良的组织病理学评估. 《欧亚肝脏胃肠病学杂志》2016;6(2):97 - 102.
