Division of Gastroenterology, University of British Columbia, Vancouver General Hospital, Vancouver, British Columbia, Canada.
Department of Medicine, Division of Gastroenterology and Hepatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.
Neurogastroenterol Motil. 2023 Apr;35(4):e14525. doi: 10.1111/nmo.14525. Epub 2023 Jan 4.
Eosinophilic esophagitis (EoE) is associated with fibrostenotic remodeling that can be objectively assessed using the functional lumen imaging probe (FLIP). This is typically done using a metric called distensibility plateau (DP). We aimed to describe a novel measure of compliance of the esophageal body and evaluate the associated clinical characteristics in EoE.
One hundred seventy-one adult patients with EoE (mean (SD) age 38 (12) years), 31% female and 35 healthy, asymptomatic controls who completed 16-cm functional luminal imaging probe (FLIP) during endoscopy, were evaluated in a cross-sectional study. The esophageal body DP and compliance were measured using a customized analysis program, with compliance calculated as (Δ esophageal body volume)/(Δ pressure) between two FLIP-filled volumes.
In controls, the median (5-95th percentile) DP was 19.8 mm (17.9-21) and esophageal body compliance was 0.37 ml/mmHg (0.18-1.1), which was greater than in EoE (DP 19 (11-21)), compliance 0.19 (0.02-0.71), p-values <0.001. Among EoE patients, 70 (41%) had normal compliance (>0.2 ml/mmHg) and normal DP (>17 mm); 11 (6%) had normal compliance and reduced DP; 34 (20%) had reduced compliance and normal DP; and 56 (33%) had reduced compliance and reduce DP. Patients with both reduced compliance and DP had the greatest proportion of severe rings (61% with EREFS score 2-3) and stricture (100%).
FLIP provides an objective evaluation of biomechanical properties of the esophageal wall that appears enhanced by complementary application of metrics of DP and esophageal body compliance.
嗜酸性粒细胞性食管炎（EoE）与纤维性狭窄重塑有关，可通过功能内腔成像探头（FLIP）进行客观评估。这通常使用称为可扩张性平台（DP）的指标来完成。我们旨在描述一种食管体顺应性的新测量方法，并评估 EoE 中的相关临床特征。
在一项横断面研究中，评估了 171 名患有 EoE（平均年龄（标准差）38（12）岁，31%为女性，35 名健康无症状对照者）的成年患者，他们在胃镜检查期间完成了 16-cm 功能内腔成像探头（FLIP）。使用定制的分析程序测量食管体 DP 和顺应性，顺应性计算为两个 FLIP 填充体积之间的（Δ食管体体积）/（Δ压力）。
在对照组中，中位数（5-95 百分位）DP 为 19.8mm（17.9-21），食管体顺应性为 0.37ml/mmHg（0.18-1.1），大于 EoE（DP 19（11-21）），顺应性为 0.19（0.02-0.71），p 值<0.001。在 EoE 患者中，70 例（41%）具有正常的顺应性（>0.2ml/mmHg）和正常的 DP（>17mm）；11 例（6%）具有正常的顺应性和降低的 DP；34 例（20%）具有降低的顺应性和正常的 DP；56 例（33%）具有降低的顺应性和降低的 DP。具有 DP 和顺应性降低的患者具有最严重的环（61%的 EREFS 评分 2-3）和狭窄（100%）比例。
FLIP 提供了对食管壁生物力学特性的客观评估，通过 DP 和食管体顺应性指标的互补应用似乎得到了增强。
