基于肌内膜抗体检测和临床风险评估的乳糜泻免活检诊断

IF 6.6 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY
Stiliano Maimaris, Annalisa Schiepatti, Daniel Ignacio Conforme Torres, Roberta Muscia, Virginia Gregorio, Claudia Delogu, Ignazio Marzio Parisi, Michele Dota, Giovanni Arpa, Carolina Cicalini, Giulio Massetti, Chiara Scarcella, Paolo Minerba, Federico Biagi
{"title":"基于肌内膜抗体检测和临床风险评估的乳糜泻免活检诊断","authors":"Stiliano Maimaris,&nbsp;Annalisa Schiepatti,&nbsp;Daniel Ignacio Conforme Torres,&nbsp;Roberta Muscia,&nbsp;Virginia Gregorio,&nbsp;Claudia Delogu,&nbsp;Ignazio Marzio Parisi,&nbsp;Michele Dota,&nbsp;Giovanni Arpa,&nbsp;Carolina Cicalini,&nbsp;Giulio Massetti,&nbsp;Chiara Scarcella,&nbsp;Paolo Minerba,&nbsp;Federico Biagi","doi":"10.1111/apt.70129","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>Interest in a biopsy-sparing diagnosis of coeliac disease in adults is growing.</p>\n </section>\n \n <section>\n \n <h3> Aims</h3>\n \n <p>To develop and prospectively validate a non-invasive diagnostic strategy for adults with suspected coeliac disease based on clinical features and endomysial antibodies (EmA).</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>We retrospectively enrolled adults investigated for coeliac disease with EmA and duodenal biopsy between January 2000 and December 2021 in cohort 1 and stratified according to age at presentation (&lt; 45 years; ≥ 45 years) and alarm symptoms. We evaluated diagnostic outcomes and accuracy of EmA. A prospective validation cohort was enrolled between Jan-2022 and Dec-2023 (cohort 2).</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Cohort 1 included 972 patients (641 F, mean age 42 ± 16); cohort 2 included 214 patients (145 F, 43 ± 18). In cohort 1, 35.4% were diagnosed with coeliac disease and 1.5% with non-coeliac enteropathies. Of the coeliac disease diagnoses, 173 (50.3%) were in patients &lt; 45 years old without alarm symptoms. No concomitant major organic disorders were diagnosed in patients with coeliac disease. EmA diagnostic accuracy was 99.1% (97.4% sensitivity; 100% specificity and PPV). Regarding non-coeliac enteropathies, 87% were diagnosed among the 139 patients aged ≥ 45 years old with alarm symptoms and negative EmA. No non-coeliac enteropathies were diagnosed in patients without alarm symptoms. Findings were confirmed in cohort 2.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>Low-risk adult patients could have been safely diagnosed with coeliac disease non-invasively based on EmA without endoscopy and duodenal biopsy. Older patients with alarm symptoms should undergo endoscopy with duodenal biopsy to avoid missing non-coeliac enteropathies. Further validation of our results is necessary.</p>\n </section>\n </div>","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"61 11","pages":"1794-1804"},"PeriodicalIF":6.6000,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/apt.70129","citationCount":"0","resultStr":"{\"title\":\"Biopsy-Sparing Diagnosis of Coeliac Disease Based on Endomysial Antibody Testing and Clinical Risk Assessment\",\"authors\":\"Stiliano Maimaris,&nbsp;Annalisa Schiepatti,&nbsp;Daniel Ignacio Conforme Torres,&nbsp;Roberta Muscia,&nbsp;Virginia Gregorio,&nbsp;Claudia Delogu,&nbsp;Ignazio Marzio Parisi,&nbsp;Michele Dota,&nbsp;Giovanni Arpa,&nbsp;Carolina Cicalini,&nbsp;Giulio Massetti,&nbsp;Chiara Scarcella,&nbsp;Paolo Minerba,&nbsp;Federico Biagi\",\"doi\":\"10.1111/apt.70129\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Background</h3>\\n \\n <p>Interest in a biopsy-sparing diagnosis of coeliac disease in adults is growing.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Aims</h3>\\n \\n <p>To develop and prospectively validate a non-invasive diagnostic strategy for adults with suspected coeliac disease based on clinical features and endomysial antibodies (EmA).</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>We retrospectively enrolled adults investigated for coeliac disease with EmA and duodenal biopsy between January 2000 and December 2021 in cohort 1 and stratified according to age at presentation (&lt; 45 years; ≥ 45 years) and alarm symptoms. We evaluated diagnostic outcomes and accuracy of EmA. A prospective validation cohort was enrolled between Jan-2022 and Dec-2023 (cohort 2).</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>Cohort 1 included 972 patients (641 F, mean age 42 ± 16); cohort 2 included 214 patients (145 F, 43 ± 18). In cohort 1, 35.4% were diagnosed with coeliac disease and 1.5% with non-coeliac enteropathies. Of the coeliac disease diagnoses, 173 (50.3%) were in patients &lt; 45 years old without alarm symptoms. No concomitant major organic disorders were diagnosed in patients with coeliac disease. EmA diagnostic accuracy was 99.1% (97.4% sensitivity; 100% specificity and PPV). Regarding non-coeliac enteropathies, 87% were diagnosed among the 139 patients aged ≥ 45 years old with alarm symptoms and negative EmA. No non-coeliac enteropathies were diagnosed in patients without alarm symptoms. Findings were confirmed in cohort 2.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusions</h3>\\n \\n <p>Low-risk adult patients could have been safely diagnosed with coeliac disease non-invasively based on EmA without endoscopy and duodenal biopsy. Older patients with alarm symptoms should undergo endoscopy with duodenal biopsy to avoid missing non-coeliac enteropathies. Further validation of our results is necessary.</p>\\n </section>\\n </div>\",\"PeriodicalId\":121,\"journal\":{\"name\":\"Alimentary Pharmacology & Therapeutics\",\"volume\":\"61 11\",\"pages\":\"1794-1804\"},\"PeriodicalIF\":6.6000,\"publicationDate\":\"2025-04-03\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://onlinelibrary.wiley.com/doi/epdf/10.1111/apt.70129\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Alimentary Pharmacology & Therapeutics\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1111/apt.70129\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"GASTROENTEROLOGY & HEPATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Alimentary Pharmacology & Therapeutics","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/apt.70129","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
引用次数: 0

摘要

对成人乳糜泻免活检诊断的兴趣正在增长。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Biopsy-Sparing Diagnosis of Coeliac Disease Based on Endomysial Antibody Testing and Clinical Risk Assessment

Background

Interest in a biopsy-sparing diagnosis of coeliac disease in adults is growing.

Aims

To develop and prospectively validate a non-invasive diagnostic strategy for adults with suspected coeliac disease based on clinical features and endomysial antibodies (EmA).

Methods

We retrospectively enrolled adults investigated for coeliac disease with EmA and duodenal biopsy between January 2000 and December 2021 in cohort 1 and stratified according to age at presentation (< 45 years; ≥ 45 years) and alarm symptoms. We evaluated diagnostic outcomes and accuracy of EmA. A prospective validation cohort was enrolled between Jan-2022 and Dec-2023 (cohort 2).

Results

Cohort 1 included 972 patients (641 F, mean age 42 ± 16); cohort 2 included 214 patients (145 F, 43 ± 18). In cohort 1, 35.4% were diagnosed with coeliac disease and 1.5% with non-coeliac enteropathies. Of the coeliac disease diagnoses, 173 (50.3%) were in patients < 45 years old without alarm symptoms. No concomitant major organic disorders were diagnosed in patients with coeliac disease. EmA diagnostic accuracy was 99.1% (97.4% sensitivity; 100% specificity and PPV). Regarding non-coeliac enteropathies, 87% were diagnosed among the 139 patients aged ≥ 45 years old with alarm symptoms and negative EmA. No non-coeliac enteropathies were diagnosed in patients without alarm symptoms. Findings were confirmed in cohort 2.

Conclusions

Low-risk adult patients could have been safely diagnosed with coeliac disease non-invasively based on EmA without endoscopy and duodenal biopsy. Older patients with alarm symptoms should undergo endoscopy with duodenal biopsy to avoid missing non-coeliac enteropathies. Further validation of our results is necessary.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
CiteScore
15.60
自引率
7.90%
发文量
527
审稿时长
3-6 weeks
期刊介绍: Alimentary Pharmacology & Therapeutics is a global pharmacology journal focused on the impact of drugs on the human gastrointestinal and hepato-biliary systems. It covers a diverse range of topics, often with immediate clinical relevance to its readership.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信