Pediatric and Pediatric Surgery Department, State University of Londrina, Londrina, Paraná, Brazil.
Department of Pathology, Federal University of Sao Paulo, Sao Paulo, Sao Paulo, Brazil.
Ann Diagn Pathol. 2022 Dec;61:152031. doi: 10.1016/j.anndiagpath.2022.152031. Epub 2022 Aug 27.
To measure the villous height, the crypt depth, and the number of intraepithelial lymphocytes/100 enterocytes of the small intestinal mucosa of children and adolescents with celiac disease; and to classify these findings according to Q- Marsh and Q-histology scales.
Retrospective study of a database from the Department of Pathology of biopsies from the second portion of the duodenum of pediatric patients. According to the histological report, three groups were established: celiac disease at diagnosis (n = 50), controls (n = 26), giardiasis (n = 10). In each biopsy, software (cellSens and Image J) evaluated 5 villous heights, 5 crypt depth and the number of intraepithelial lymphocytes/100 enterocytes.
The celiac group had the lowest mean villous height (197.83 μm) of all three groups (control = 477.70 μm; giardiasis = 397.04 μm. The celiac group's villous:crypt ratio (0.78) was significantly lower than the control group (1.89). The number of intraepithelial lymphocytes ≥25 was exclusive to the celiac group, with a sensitivity and specificity of 100 %. Only celiac patients were included in types 2 and 3 of the Q-histology classification.
Celiac disease patients showed shorter villous height than other groups, and the number of intraepithelial lymphocytes ≥25 was the best parameter to differentiate celiac from controls and giardiasis groups. Intraepithelial lymphocytes ≥25/100 enterocytes associated with any degree of villous atrophy, the classic Marsh 3 type, set the histological parameters of celiac disease. Quantitative histology is a valuable tool for diagnosing celiac disease, enabling histological changes in a short time, and the Q-histology scale appears to be more suitable than the Q-Marsh scale.
测量乳糜泻患儿和青少年小肠黏膜的绒毛高度、隐窝深度和上皮内淋巴细胞/100 个肠细胞数，并根据 Q-Marsh 和 Q-组织学量表对这些发现进行分类。
回顾性研究来自儿科患者十二指肠第二段活检的病理学数据库。根据组织学报告，建立了三组：乳糜泻诊断时（n=50）、对照组（n=26）、贾第虫病（n=10）。在每个活检中，软件（cellSens 和 Image J）评估了 5 个绒毛高度、5 个隐窝深度和上皮内淋巴细胞/100 个肠细胞数。
乳糜泻组的平均绒毛高度（197.83 μm）在三组中最低（对照组为 477.70 μm；贾第虫病组为 397.04 μm）。乳糜泻组的绒毛：隐窝比（0.78）明显低于对照组（1.89）。上皮内淋巴细胞≥25 的患者仅见于乳糜泻组，其敏感性和特异性均为 100%。只有乳糜泻患者被纳入 Q-组织学分类的 2 型和 3 型。
乳糜泻患者的绒毛高度比其他组短，上皮内淋巴细胞≥25 是区分乳糜泻与对照组和贾第虫病组的最佳参数。上皮内淋巴细胞≥25/100 个肠细胞与任何程度的绒毛萎缩相关，经典的 Marsh 3 型确立了乳糜泻的组织学参数。定量组织学是诊断乳糜泻的一种有价值的工具，可在短时间内观察到组织学变化，且 Q-组织学量表似乎比 Q-Marsh 量表更适用。
