Schmitz-Moormann P, Pittner P M, Reichmann L, Massarat S
Pathol Res Pract. 1984 May;178(5):499-507. doi: 10.1016/S0344-0338(84)80011-4.
In 48 patients, suffering from an endoscopically verified ulcerative or nonulcerative duodenitis, biopsies of the bulb and of the lower duodenum have been studied with quantitative histological methods. The evaluation of the data with simple and multivariate statistical methods revealed: In healthy duodenal mucosa the height of the villous epithelium significantly decreases with rising age, while the cellular infiltration of the stroma increases. Conclusive, sex dependent differences are not present. Many histological variables are significantly correlated to the endoscopical degree of inflammation, if the endoscopically normal mucosa of the lower duodenum is used as normal control. In contrast, the endoscopically normal bulb mucosa histologically showed inflammatory alterations in the majority of cases. As shown by a multivariate discriminant analysis, a correct histological diagnosis of duodenitis will be reached in nearly all patients, if a biopsy of the endoscopically normal lower duodenum of the same patients is used as matched control. As shown by a multiple stepwise regression analysis, the same procedure results in a good correspondence of the endoscopically estimated degree of inflammation and the values, calculated from histology. In some patients, the lower duodenum slightly takes part in the inflammation of the bulb. But no significant correlation was found between the calculated degree of inflammation of the bulb and of the lower duodenum, neither in ulcerative duodenitis nor in nonulcerative duodenitis. From a practical point of view, our findings elucidate, that the simultaneous histological examination of mucosa of the bulb and of endoscopically healthy mucosa of the lower duodenum will be an essential help in the diagnosis and grading of duodenitis and should be introduced as routine method.
对48例经内镜证实患有溃疡性或非溃疡性十二指肠炎的患者，采用定量组织学方法对十二指肠球部和十二指肠下段进行了活检研究。运用简单和多变量统计方法对数据进行评估后发现：在健康的十二指肠黏膜中，绒毛上皮的高度会随着年龄增长而显著降低，而基质的细胞浸润则会增加。可以确定的是，不存在性别差异。如果将十二指肠下段内镜检查正常的黏膜作为正常对照，许多组织学变量与内镜下炎症程度显著相关。相比之下，内镜检查正常的十二指肠球部黏膜在大多数情况下组织学上显示有炎症改变。多变量判别分析表明，如果将同一患者内镜检查正常的十二指肠下段活检作为匹配对照，几乎所有患者都能得到正确的十二指肠炎组织学诊断。多步回归分析表明，同样的操作可使内镜评估的炎症程度与根据组织学计算得出的值有良好的对应关系。在一些患者中，十二指肠下段轻微参与球部的炎症。但在溃疡性十二指肠炎和非溃疡性十二指肠炎中，十二指肠球部和十二指肠下段计算出的炎症程度之间均未发现显著相关性。从实际角度来看，我们的研究结果表明，同时对十二指肠球部黏膜和内镜检查健康的十二指肠下段黏膜进行组织学检查，将对十二指肠炎的诊断和分级有重要帮助，应作为常规方法采用。
