Endocytoscopy for the detection of microstructural features in adult patients with celiac sprue: a prospective, blinded endocytoscopy-conventional histology correlation study.
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Endocytoscopy for the detection of microstructural features in adult patients with celiac sprue: a prospective, blinded endocytoscopy-conventional histology correlation study. / Pohl, Heiko; Rösch, Thomas; Tanczos, Barbara T; Rudolph, Birgit; Schlüns, Karsten; Baumgart, Daniel C.
In: GASTROINTEST ENDOSC, Vol. 70, No. 5, 5, 01.11.2009, p. 933-941.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Endocytoscopy for the detection of microstructural features in adult patients with celiac sprue: a prospective, blinded endocytoscopy-conventional histology correlation study.
AU - Pohl, Heiko
AU - Rösch, Thomas
AU - Tanczos, Barbara T
AU - Rudolph, Birgit
AU - Schlüns, Karsten
AU - Baumgart, Daniel C
PY - 2009/11/1
Y1 - 2009/11/1
N2 - BACKGROUND: Endocytoscopy (EC) is a novel technique that allows magnified live inspection of the intestinal mucosa. OBJECTIVE: To evaluate EC for the detection of key pathological findings in patients with celiac sprue. DESIGN: A total of 166 EC recordings were prospectively acquired. Matched videos, images, and biopsy specimens were obtained by duodenal argon beamer labeling of the respective sites. SETTING: Academic tertiary referral center. PATIENTS: Forty patients (mean age 51.5 years, 70% women) with established (n = 32) or suspected (n = 8) celiac disease (CD). INTERVENTIONS: A validated scoring system (Marsh classification) was used to assess disease activity. EC criteria were independently evaluated by 2 gastroenterologists and 1 pathologist. MAIN OUTCOME MEASUREMENTS: The primary endpoint was to examine EC correlation with conventional CD histology. RESULTS: Of 166 duodenal biopsy sites, 23% were classified as Marsh III (moderate to severe), 10% as Marsh I (mild), and 67% as Marsh 0 (normal). Using the 450x magnification, we found that identification of crypts was diagnostic for celiac pathology. Four criteria were significant predictors of Marsh III pathology when adjusted by multivariate analysis: low number of villi per visual field (
AB - BACKGROUND: Endocytoscopy (EC) is a novel technique that allows magnified live inspection of the intestinal mucosa. OBJECTIVE: To evaluate EC for the detection of key pathological findings in patients with celiac sprue. DESIGN: A total of 166 EC recordings were prospectively acquired. Matched videos, images, and biopsy specimens were obtained by duodenal argon beamer labeling of the respective sites. SETTING: Academic tertiary referral center. PATIENTS: Forty patients (mean age 51.5 years, 70% women) with established (n = 32) or suspected (n = 8) celiac disease (CD). INTERVENTIONS: A validated scoring system (Marsh classification) was used to assess disease activity. EC criteria were independently evaluated by 2 gastroenterologists and 1 pathologist. MAIN OUTCOME MEASUREMENTS: The primary endpoint was to examine EC correlation with conventional CD histology. RESULTS: Of 166 duodenal biopsy sites, 23% were classified as Marsh III (moderate to severe), 10% as Marsh I (mild), and 67% as Marsh 0 (normal). Using the 450x magnification, we found that identification of crypts was diagnostic for celiac pathology. Four criteria were significant predictors of Marsh III pathology when adjusted by multivariate analysis: low number of villi per visual field (
KW - Biopsy
KW - Diagnosis, Differential
KW - Humans
KW - Male
KW - Female
KW - Middle Aged
KW - Prospective Studies
KW - Reproducibility of Results
KW - Endoscopy, Gastrointestinal methods
KW - Celiac Disease diagnosis
KW - Duodenum pathology
KW - Intestinal Mucosa pathology
KW - Biopsy
KW - Diagnosis, Differential
KW - Humans
KW - Male
KW - Female
KW - Middle Aged
KW - Prospective Studies
KW - Reproducibility of Results
KW - Endoscopy, Gastrointestinal methods
KW - Celiac Disease diagnosis
KW - Duodenum pathology
KW - Intestinal Mucosa pathology
U2 - 10.1016/j.gie.2009.04.043
DO - 10.1016/j.gie.2009.04.043
M3 - SCORING: Journal article
C2 - 19560762
VL - 70
SP - 933
EP - 941
JO - GASTROINTEST ENDOSC
JF - GASTROINTEST ENDOSC
SN - 0016-5107
IS - 5
M1 - 5
ER -