Factors Associated With Adequate Lamina Propria Sampling and Presence of Lamina Propria Fibrosis in Children with Eosinophilic Esophagitis
Autor: | Hernan Correa, Sari Acra, Evan S. Dellon, Girish Hiremath, Yash A. Choksi |
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Rok vydání: | 2021 |
Předmět: |
Male
medicine.medical_specialty medicine.drug_class Biopsy Proton-pump inhibitor Gastroenterology Article 03 medical and health sciences 0302 clinical medicine Fibrosis Internal medicine medicine Humans Child Eosinophilic esophagitis Retrospective Studies Lamina propria Mucous Membrane Hepatology medicine.diagnostic_test Esophagogastroduodenoscopy business.industry Retrospective cohort study Eosinophilic Esophagitis Odds ratio Eosinophil medicine.disease medicine.anatomical_structure 030220 oncology & carcinogenesis 030211 gastroenterology & hepatology business |
Zdroj: | Clin Gastroenterol Hepatol |
ISSN: | 1542-3565 |
Popis: | Background & Aims Esophageal biopsies in children with eosinophilic esophagitis (EoE) are often inadequate for assessment of lamina propria and lamina propria fibrosis (LPF). For children with EoE, little is known about the factors associated with adequate lamina propria (aLP) sampling or the relationship among epithelial features in esophageal biopsies with and without LPF. We aimed to evaluate aLP in esophageal biopsies from children with and without EoE, identify factors associated with aLP and LPF, and examine the relationship among epithelial features in biopsies with and without LPF in children with EoE. Methods In a retrospective study, we analyzed clinical, endoscopic, and histologic data from 217 children (124 with EoE and 94 without EoE [controls]) using descriptive statistics, logistic regression, Spearman’s correlation, and receiver operating characteristic curve analysis. Active and inactive EoE were defined per the 2011 consensus guidelines. Results aLP was observed in biopsies from higher proportion of children with EoE (69%) than controls (31%) (P=.0001). Active EoE was independently associated with aLP (adjusted odds ratio [aOR], 4.23; 95% CI, 1.00–18.13; P=.05). Patient sex (aOR for boys, 8.37; 95% CI, 1.23–56.74; P=.03) and peak eosinophil count (aOR, 1.02; 95% CI, 1.01–1.04; P=.01) were independently associated with LPF. Epithelial features were strongly interrelated in biopsies with LPF, and the presence of specific epithelial features was associated with LPF. Conclusions aLP was observed in a higher proportion of esophageal biopsies from children with EoE than controls. EoE status, patient sex, and peak eosinophil count were associated with aLP sampling and LPF. Given the intricate relationship between epithelial features and LPF, computational models can be developed to identify children with esophageal biopsies without aLP who are at risk for LPF. |
Databáze: | OpenAIRE |
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