Gastric metaplasia of the duodenal mucosa in Crohn’s disease: novel histological and endoscopic findings
Background and study aims Upper gastrointestinal endoscopy and biopsy are useful for differential diagnosis of Crohn’s disease (CD) of the large intestine and ulcerative colitis (UC). We aimed to identify novel histopathological and endoscopic findings in the upper gastrointestinal tract in patients...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Georg Thieme Verlag KG
2021-01-01
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| Series: | Endoscopy International Open |
| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.1055/a-1313-7239 |
| _version_ | 1830359365328044032 |
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| author | Go Ikezono Kenshi Yao Kentaro Imamura Takao Kanemitsu Masaki Miyaoka Akikazu Hirano Kazuhiro Takeda Takashi Hisabe Toshiharu Ueki Hiroshi Tanabe Atsuko Ota Seiji Haraoka Akinori Iwashita |
| author_facet | Go Ikezono Kenshi Yao Kentaro Imamura Takao Kanemitsu Masaki Miyaoka Akikazu Hirano Kazuhiro Takeda Takashi Hisabe Toshiharu Ueki Hiroshi Tanabe Atsuko Ota Seiji Haraoka Akinori Iwashita |
| author_sort | Go Ikezono |
| collection | DOAJ |
| description | Background and study aims Upper gastrointestinal endoscopy and biopsy are useful for differential diagnosis of Crohn’s disease (CD) of the large intestine and ulcerative colitis (UC). We aimed to identify novel histopathological and endoscopic findings in the upper gastrointestinal tract in patients with CD who did not have Helicobacter pylori infection.
Patients and methods Upper gastrointestinal endoscopy was performed on patients with CD and UC. Mucosal lesions detected were subsequently observed using magnifying endoscopy with narrow-band imaging (M-NBI), following which biopsy was performed. When no mucosal lesion was detected on conventional endoscopy, M-NBI and biopsy were performed on four sites: the gastric body, gastric antrum, duodenal bulb, and second portion of the duodenum.
Results The prevalences of gastric metaplasia (GM) were 48 % (24/50) and 16 % (8/50) in the CD and UC groups, showing a significant difference (P = 0.001). In 23 of 24 patients with histologically proven GM in the CD group, mucosal lesions were detected using conventional white-light imaging (C-WLI). In 22 of 24 patients with histologically proven GM in the CD group, disappearance of normal villous structure and the presence of curved marginal crypt epithelium were noted using magnifying endoscopic findings characteristic of GM (M-GM). A combination of C-WLI and M-NBI yielded a significantly increased specificity (P = 0.004) and accuracy (P = 0.039).
Conclusions The prevalence of GM in the duodenal mucosa was significantly higher in patients with CD than in controls. The identified endoscopic findings may be useful as novel indicators for the histological diagnosis of GM in the duodenum. |
| first_indexed | 2024-12-20T02:58:37Z |
| format | Article |
| id | doaj.art-2a6cdd81044e4a19822604a70bf126d1 |
| institution | Directory Open Access Journal |
| issn | 2364-3722 2196-9736 |
| language | English |
| last_indexed | 2024-12-20T02:58:37Z |
| publishDate | 2021-01-01 |
| publisher | Georg Thieme Verlag KG |
| record_format | Article |
| series | Endoscopy International Open |
| spelling | doaj.art-2a6cdd81044e4a19822604a70bf126d12022-12-21T19:55:50ZengGeorg Thieme Verlag KGEndoscopy International Open2364-37222196-97362021-01-010902E181E18910.1055/a-1313-7239Gastric metaplasia of the duodenal mucosa in Crohn’s disease: novel histological and endoscopic findingsGo Ikezono0Kenshi Yao1Kentaro Imamura2Takao Kanemitsu3Masaki Miyaoka4Akikazu Hirano5Kazuhiro Takeda6Takashi Hisabe7Toshiharu Ueki8Hiroshi Tanabe9Atsuko Ota10Seiji Haraoka11Akinori Iwashita12Department of Endoscopy, Fukuoka University Chikushi HospitalDepartment of Endoscopy, Fukuoka University Chikushi HospitalDepartment of Endoscopy, Fukuoka University Chikushi HospitalDepartment of Endoscopy, Fukuoka University Chikushi HospitalDepartment of Endoscopy, Fukuoka University Chikushi HospitalDepartment of Endoscopy, Fukuoka University Chikushi HospitalDepartment of Endoscopy, Fukuoka University Chikushi HospitalDepartment of Endoscopy, Fukuoka University Chikushi HospitalDepartment of Endoscopy, Fukuoka University Chikushi HospitalDepartment of Pathology, Fukuoka, University Chikushi HospitalDepartment of Pathology, Fukuoka, University Chikushi HospitalDepartment of Pathology, Fukuoka, University Chikushi HospitalDepartment of Pathology, Fukuoka, University Chikushi HospitalBackground and study aims Upper gastrointestinal endoscopy and biopsy are useful for differential diagnosis of Crohn’s disease (CD) of the large intestine and ulcerative colitis (UC). We aimed to identify novel histopathological and endoscopic findings in the upper gastrointestinal tract in patients with CD who did not have Helicobacter pylori infection. Patients and methods Upper gastrointestinal endoscopy was performed on patients with CD and UC. Mucosal lesions detected were subsequently observed using magnifying endoscopy with narrow-band imaging (M-NBI), following which biopsy was performed. When no mucosal lesion was detected on conventional endoscopy, M-NBI and biopsy were performed on four sites: the gastric body, gastric antrum, duodenal bulb, and second portion of the duodenum. Results The prevalences of gastric metaplasia (GM) were 48 % (24/50) and 16 % (8/50) in the CD and UC groups, showing a significant difference (P = 0.001). In 23 of 24 patients with histologically proven GM in the CD group, mucosal lesions were detected using conventional white-light imaging (C-WLI). In 22 of 24 patients with histologically proven GM in the CD group, disappearance of normal villous structure and the presence of curved marginal crypt epithelium were noted using magnifying endoscopic findings characteristic of GM (M-GM). A combination of C-WLI and M-NBI yielded a significantly increased specificity (P = 0.004) and accuracy (P = 0.039). Conclusions The prevalence of GM in the duodenal mucosa was significantly higher in patients with CD than in controls. The identified endoscopic findings may be useful as novel indicators for the histological diagnosis of GM in the duodenum.http://www.thieme-connect.de/DOI/DOI?10.1055/a-1313-7239 |
| spellingShingle | Go Ikezono Kenshi Yao Kentaro Imamura Takao Kanemitsu Masaki Miyaoka Akikazu Hirano Kazuhiro Takeda Takashi Hisabe Toshiharu Ueki Hiroshi Tanabe Atsuko Ota Seiji Haraoka Akinori Iwashita Gastric metaplasia of the duodenal mucosa in Crohn’s disease: novel histological and endoscopic findings Endoscopy International Open |
| title | Gastric metaplasia of the duodenal mucosa in Crohn’s disease: novel histological and endoscopic findings |
| title_full | Gastric metaplasia of the duodenal mucosa in Crohn’s disease: novel histological and endoscopic findings |
| title_fullStr | Gastric metaplasia of the duodenal mucosa in Crohn’s disease: novel histological and endoscopic findings |
| title_full_unstemmed | Gastric metaplasia of the duodenal mucosa in Crohn’s disease: novel histological and endoscopic findings |
| title_short | Gastric metaplasia of the duodenal mucosa in Crohn’s disease: novel histological and endoscopic findings |
| title_sort | gastric metaplasia of the duodenal mucosa in crohn s disease novel histological and endoscopic findings |
| url | http://www.thieme-connect.de/DOI/DOI?10.1055/a-1313-7239 |
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