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结肠镜引导下结肠测压导管放置时黏膜活检的诊断价值。

Diagnostic Utility of Mucosal Biopsies Taken During Colonoscopy-Guided Colonic Manometry Catheter Placement.

机构信息

From the Division of Pediatric Gastroenterology, Hepatology and Nutrition, Monroe Carell Jr. Children's Hospital at Vanderbilt University, Nashville, TN.

the Department of Pediatrics, Baylor College of Medicine, Houston, TX.

出版信息

J Pediatr Gastroenterol Nutr. 2023 Nov 1;77(5):655-660. doi: 10.1097/MPG.0000000000003907. Epub 2023 Aug 7.

Abstract

OBJECTIVES

The diagnostic utility of mucosal biopsies taken during colonoscopy-guided colonic manometry catheter placement is unknown. The aims of our study were to determine the frequency and histopathology results of mucosal biopsies during these procedures and to assess whether there were any associations between the histology or gross findings with manometry results.

METHODS

We performed a retrospective chart review of children who had a colonic manometry study completed between 2008 and 2020 at a quaternary children's hospital. We captured patient demographics, biopsy locations, histopathology results, gross endoscopy findings, and manometry results. The chi-squared test and when appropriate Fisher exact test was used to evaluate categorical associations.

RESULTS

One hundred forty-eight patients were included. One hundred eighteen (80%) had colonic biopsy and 63 (43%) had ileal biopsy. Colonic histology findings, which patients could have multiple, included lymphonodular hyperplasia (34%), normal (27%), chronic inflammation (24%), melanosis coli (21%), colonic eosinophilia (10%), and acute inflammation (8%). Ileal histology findings included increased Peyer patches (44%), normal (44%), acute inflammation (11%), chronic inflammation (3%), eosinophilia (5%), and eosinophilic ileitis (3%). The majority of acute and chronic inflammation was graded as mild. There were no statistically significant associations of histology to gross endoscopy or manometry findings.

CONCLUSIONS

Colonic biopsies are obtained in the majority of patients presenting for colonic manometry evaluation with ileal biopsies obtained less frequently. Histopathology findings are noted frequently, but the majority are the result of or did not impact clinical care. There were no associations between abnormal histopathology or abnormal gross endoscopy findings with colonic manometry results.

摘要

目的

在结肠镜引导下进行结肠测压导管放置时,黏膜活检的诊断效用尚不清楚。本研究旨在确定这些操作中黏膜活检的频率和组织病理学结果,并评估组织学或大体发现与测压结果之间是否存在任何关联。

方法

我们对 2008 年至 2020 年期间在一家四级儿童医院完成结肠测压研究的儿童进行了回顾性图表审查。我们记录了患者的人口统计学资料、活检部位、组织病理学结果、内镜下大体发现和测压结果。使用卡方检验和适当的 Fisher 确切检验评估分类关联。

结果

共纳入 148 例患者。118 例(80%)进行了结肠活检,63 例(43%)进行了回肠活检。结肠组织学发现,患者可能有多种表现,包括淋巴滤泡增生(34%)、正常(27%)、慢性炎症(24%)、结肠黑变病(21%)、结肠嗜酸性粒细胞增多(10%)和急性炎症(8%)。回肠组织学发现包括增生性派尔集合淋巴结(44%)、正常(44%)、急性炎症(11%)、慢性炎症(3%)、嗜酸性粒细胞增多(5%)和嗜酸性粒细胞性回肠炎(3%)。大多数急性和慢性炎症均为轻度。组织学与内镜下大体发现或测压结果之间无统计学显著关联。

结论

在接受结肠测压评估的大多数患者中都进行了结肠活检,而回肠活检的比例较低。经常观察到组织病理学发现,但大多数是或没有影响临床治疗。异常组织病理学或异常内镜下大体发现与结肠测压结果之间无关联。

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