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针对因先天性巨结肠症接受检查的儿童，直肠吸引活检在体重方面的诊断效能。

Diagnostic Efficacy of Rectal Suction Biopsy with Regard to Weight in Children Investigated for Hirschsprung's Disease.

作者信息

Fransson Emma, Granéli Christina, Hagelsteen Kristine, Tofft Louise, Hambraeus Mette, Munoz Mitev Rodrigo Urdar, Gisselsson David, Stenström Pernilla

机构信息

Department of Pediatric Surgery, Institution of Clinical Sciences, Skåne University Hospital, Lund University, 22185 Lund, Sweden.

Clinical Genetics and Pathology, Laboratory Medicine Skåne, University Hospital, 22185 Lund, Sweden.

出版信息

Children (Basel). 2022 Jan 18;9(2):124. doi: 10.3390/children9020124.

DOI:10.3390/children9020124
PMID:35204845
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8870311/
Abstract

BACKGROUND/AIM: Diagnostic efficacy, defined as the percentage of rectal suction biopsy (RSB) specimens sufficient enough to determine the absence of ganglia cells in Hirschsprung's disease (HD) diagnosis, has been reported to be low, requiring repeated biopsies. The aim was to explore whether RSB diagnostic efficacy was influenced by the child's weight and to ascertain whether RSB efficacy differed between aganglionic and ganglionic tissue.

MATERIALS AND METHODS

Efficacy analyses were conducted in a national HD-center's register on children 0-15 kg, examined between 2011-2019. First-time RSB diagnostic efficacy was correlated to the children's weight and final HD diagnosis.

RESULTS

Among the 84 children who had first-time RSB, the overall diagnostic efficacy was 85% (71/84). The efficacy was higher among children weighing less than the identified cut-off of 9.0 kg (89% in 0-9.0 kg versus 62% in 9.01-15.0 kg, = 0.026). Among children diagnosed with HD, 96% (26/27) weighed 0-9.0 kg. In this weight group, the diagnostic efficacy was lower in aganglionosis compared to ganglionosis (77%; 20/26 versus 96%; 43/45), = 0.045).

CONCLUSIONS

The RSB diagnostic efficacy was significantly higher in children weighing less than 9.0 kg and was less in aganglionic compared to ganglionic tissue. Therefore, weight can be useful to predict RSB diagnostic efficacy.

摘要

背景/目的：诊断效能定义为直肠吸引活检（RSB）标本足以确定先天性巨结肠（HD）诊断中无神经节细胞的百分比，据报道该诊断效能较低，需要重复活检。目的是探讨RSB诊断效能是否受儿童体重影响，并确定无神经节组织和有神经节组织之间的RSB效能是否存在差异。

材料与方法

在一家全国性HD中心的登记册中，对2011年至2019年期间检查的0至15千克儿童进行效能分析。首次RSB诊断效能与儿童体重及最终HD诊断相关。

结果

在84例首次进行RSB的儿童中，总体诊断效能为85%（71/84）。体重低于确定的9.0千克临界值的儿童中，诊断效能更高（0至9.0千克组为89%，9.01至15.0千克组为62%，P = 0.0

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e577/8870311/03d627801347/children-09-00124-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e577/8870311/cbfe24066a3a/children-09-00124-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e577/8870311/c8fd62fa789b/children-09-00124-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e577/8870311/1c22c6a7a5ea/children-09-00124-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e577/8870311/03d627801347/children-09-00124-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e577/8870311/cbfe24066a3a/children-09-00124-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e577/8870311/c8fd62fa789b/children-09-00124-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e577/8870311/1c22c6a7a5ea/children-09-00124-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e577/8870311/03d627801347/children-09-00124-g004.jpg

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本文引用的文献

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World J Pediatr Surg. 2020 Jan 27;3(1):e000080. doi: 10.1136/wjps-2019-000080. eCollection 2020.
2
Suction Rectal Biopsy is Accurate in Late Preterm Infants with Suspected Hirschsprung Disease.经肛门直肠吸引活检术在疑似先天性巨结肠病的晚期早产儿中准确。
J Pediatr Surg. 2020 Jan;55(1):67-70. doi: 10.1016/j.jpedsurg.2019.09.055. Epub 2019 Oct 25.
3
Accuracy of Suction Rectal Biopsy for Diagnosis of Hirschsprung's Disease in Neonates.
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BMC Pediatr. 2022 Dec 20;22(1):723. doi: 10.1186/s12887-022-03792-3.
经直肠吸引活检诊断新生儿先天性巨结肠症的准确性
Eur J Pediatr Surg. 2019 Oct;29(5):425-430. doi: 10.1055/s-0038-1667040. Epub 2018 Aug 1.
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