Department of Pathology, Medicine (Digestive Diseases) and Human and Translational Immunology, Yale University School of Medicine, New Haven, Connecticut.
Department of Medicine, Surgery, Dentistry, Scuola Medica Salernitana, University of Salerno, Baronissi, Salerno, Italy.
Gastroenterology. 2024 Jun;167(1):79-89. doi: 10.1053/j.gastro.2024.01.031. Epub 2024 Jan 30.
The accumulating data regarding a non-biopsy diagnosis of celiac disease has led to its adoption in certain scenarios, although debate on whether and when to use non-biopsy criteria in clinical practice is ongoing. Despite the growing popularity and evidence basis for a biopsy-free approach to diagnosis in the context of highly elevated serologies, there will continue to be a role for a biopsy in some groups. This review summarizes the current evidence supporting a non-biopsy approach and arguments supporting continued reliance on biopsy, and focuses on opportunities to improve both approaches.
关于非活检诊断乳糜泻的数据不断增加,导致其在某些情况下被采用,尽管关于是否以及何时在临床实践中使用非活检标准仍存在争议。尽管在高度升高的血清学情况下,无活检方法诊断的普及程度和证据基础不断增加,但在某些情况下仍将需要进行活检。本文综述了支持非活检方法的现有证据以及支持继续依赖活检的论点,并重点讨论了改进这两种方法的机会。