潜在乳糜泻患者上皮内淋巴细胞计数的评估

IF 2.2 4区 医学 Q4 IMMUNOLOGY
Apmis Pub Date : 2025-03-18 DOI:10.1111/apm.70015
Roberta Mandile, Mariantonia Maglio, Antonella Marano, Luciano Rapacciuolo, Valentina Discepolo, Riccardo Troncone, Renata Auricchio
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引用次数: 0

摘要

上皮内淋巴细胞(IELs)计数是乳糜泻(CD)诊断的核心,可以直接在苏木精和伊红(H&;E)染色的石蜡切片上进行,也可以在免疫组织化学(IHC)用抗cd3染色的最佳切割温度复合物(OCT)包埋的冷冻切片上进行。我们在一个大样本的剖面上评估了这两种技术在Marsh分级中的一致性。共纳入280名正常肠道结构患者,210名潜在乳糜泻(PCD)患者和70名对照组(CTR)。在H&;E组织学评估中,136/280例为Marsh-0(显示25个IELs/100个肠细胞)和144例为Marsh-1,而在IHC评估中,191例为Marsh-0(显示≤34 CD3+/mm上皮)和89例为Marsh-1。总体一致性为66.8%(48.6%为Marsh-1, 86%为Marsh-0), Cohen Kappa值为0.33。在PCD组中,总体一致性为63% (45.6% Marsh-1和84% Marsh-0), Cohen Kappa值为0.26,而在CTR组中,总体一致性为77% (60% Marsh-1, 90% Marsh-0), Cohen Kappa值为0.54。两组间差异有统计学意义(p < 0.05)。综上所述,非cd患者的IELs计数与IHC评估之间的一致性较低(Kappa Cohen 0.54), PCD患者的IELs计数一致性更高(0.26)。在根据所使用的技术将患者分为0级或1级时,必须谨慎。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Assessment of Intraepithelial Lymphocytes Count in Potential Celiac Disease

Assessment of Intraepithelial Lymphocytes Count in Potential Celiac Disease

Intraepithelial lymphocytes (IELs) count, central for coeliac disease (CD) diagnosis, can be performed either directly on hematoxylin and eosin (H&E)–stained paraffined sections or on optimal-cutting-temperature-compound (OCT)-embedded frozen sections stained by immunohistochemistry (IHC) with anti-CD3. We evaluated the concordance in Marsh grading between these two techniques on a large sample of sections. A total of 280 patients with a normal intestinal architecture, 210 potential celiac disease (PCD) patients, and 70 controls (CTR) were included. At the H&E histological evaluation, 136/280 were classified as Marsh-0 (showing < 25 IELs/100 enterocytes) and 144 Marsh-1, while at the IHC evaluation, 191 were classified as Marsh-0 (showing ≤ 34 CD3+/mm of epithelium) and 89 Marsh-1. The overall concordance was 66.8% (48.6% Marsh-1 and 86% Marsh-0) with a Cohen Kappa value of 0.33. In the PCD group, the overall concordance was 63% (45.6% Marsh-1 and 84% Marsh-0) with a Cohen Kappa value of 0.26, while in the CTR group it was 77% (60% Marsh-1, 90% Marsh-0) with a Cohen Kappa value of 0.54. Differences between the two groups were statistically significant (p < 0.05). In conclusion, the concordance of IELs counts between histological and IHC evaluation is low (Kappa Cohen 0.54) in no-CD and even more in PCD patients (0.26). Caution must be paid when classifying a patient as Marsh-0 or Marsh-1 according to the technique used.

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来源期刊
Apmis
Apmis 医学-病理学
CiteScore
5.20
自引率
0.00%
发文量
91
审稿时长
2 months
期刊介绍: APMIS, formerly Acta Pathologica, Microbiologica et Immunologica Scandinavica, has been published since 1924 by the Scandinavian Societies for Medical Microbiology and Pathology as a non-profit-making scientific journal.
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