Mee A S, Burke M, Vallon A G, Newman J, Cotton P B
Br Med J (Clin Res Ed). 1985 Sep 21;291(6498):769-72. doi: 10.1136/bmj.291.6498.769.
Biopsy specimens of the small bowel were obtained from 40 patients suspected of having malabsorption. Four different techniques were used at a single session--namely, endoscopic biopsy of the descending duodenum using paediatric and standard size forceps and suction capsule biopsy of the descending duodenum and the proximal jejunum. Specimens were compared for size, adequacy, and ability to confirm or exclude mucosal abnormality. Fourteen patients had villous atrophy. In all patients four biopsy specimens were obtained with paediatric endoscopic forceps and four with standard endoscopic forceps. No capsule biopsy specimen was retrieved from the duodenum in three patients and from the jejunum in five patients. Specimens were considered to be adequate in 36 patients when paediatric forceps were used, in 39 when standard forceps were used, in 28 on duodenal capsule biopsy, and in 32 on jejunal capsule biopsy. This study indicates that the most reliable method for diagnosing or excluding villous atrophy is endoscopic forceps biopsy of the descending duodenum, provided that at least four specimens are obtained with standard size forceps.
从40名疑似吸收不良的患者身上获取了小肠活检标本。在同一次操作中使用了四种不同的技术，即使用儿科和标准尺寸活检钳对降部十二指肠进行内镜活检，以及对降部十二指肠和空肠近端进行吸引式胶囊活检。对标本的大小、充足性以及确认或排除黏膜异常的能力进行了比较。14名患者存在绒毛萎缩。所有患者均使用儿科内镜活检钳获取了4份活检标本，使用标准内镜活检钳获取了4份活检标本。3名患者未从十二指肠获取胶囊活检标本，5名患者未从空肠获取胶囊活检标本。使用儿科活检钳时，36名患者的标本被认为是充足的；使用标准活检钳时，39名患者的标本被认为是充足的；十二指肠胶囊活检时，28名患者的标本被认为是充足的；空肠胶囊活检时，32名患者的标本被认为是充足的。这项研究表明，诊断或排除绒毛萎缩最可靠的方法是使用标准尺寸活检钳对降部十二指肠进行内镜活检钳活检，前提是至少获取4份标本。
