Black D D, Haggitt R C, Whitington P F
Department of Pediatrics, University of Tennessee Center for the Health Sciences, Memphis.
J Pediatr Gastroenterol Nutr. 1988 May-Jun;7(3):353-8. doi: 10.1097/00005176-198805000-00007.
The histopathologic abnormalities in endoscopic biopsies from the stomach and duodenal bulb were correlated with the visual findings of upper gastrointestinal endoscopy in 94 children (mean age, 8.4 years; 51 boys and 43 girls) with a variety of complaints. Histology was graded by observers blinded to the endoscopic findings, and both endoscopy and histology were graded using scales reflecting increasing severity with increasing grade. In all three locations studied (gastric body, antrum, and duodenal bulb), endoscopic grade was significantly higher than the histologic grade. Correlation was especially poor with mild endoscopic findings such as erythema and granularity/nodularity, which had little predictive value for histologic inflammation. Few patients had severe disease with eight of 94 having ulcer by endoscopy and seven of 94 having greater than grade 2 histologic disease in any location. We conclude that endoscopy without biopsy should not be used to diagnose gastroduodenal inflammation in pediatric patients.
对94名（平均年龄8.4岁，51名男孩和43名女孩）有各种不适症状的儿童进行了研究，分析了胃和十二指肠球部内镜活检的组织病理学异常与上消化道内镜检查的视觉结果之间的相关性。组织学由对内镜检查结果不知情的观察者进行分级，内镜检查和组织学均使用反映随着分级增加严重程度也增加的量表进行分级。在研究的所有三个部位（胃体、胃窦和十二指肠球部），内镜分级显著高于组织学分级。内镜检查结果较轻如红斑和颗粒状/结节状时，相关性尤其差，这些表现对组织学炎症几乎没有预测价值。很少有患者患有严重疾病，94名患者中8名内镜检查发现溃疡，94名患者中7名在任何部位组织学疾病超过2级。我们得出结论，儿科患者中不应使用无活检的内镜检查来诊断胃十二指肠炎症。
