Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Schneider, NI; Plieschnegger, W; Geppert, M; Wigginghaus, B; Hoess, GM; Eherer, A; Wolf, EM; Rehak, P; Vieth, M; Langner, C.
Validation study of the Esohisto consensus guidelines for the recognition of microscopic esophagitis (histoGERD Trial).
Hum Pathol. 2014; 45(5):994-1002
Doi: 10.1016/j.humpath.2013.12.013
Web of Science
PubMed
FullText
FullText_MUG
- Führende Autor*innen der Med Uni Graz
- Langner Cord
- Co-Autor*innen der Med Uni Graz
- Eherer Andreas
- Rehak Peter
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- Abstract:
- In patients with gastroesophageal reflux disease (GERD), histology is generally believed to be a tool of limited diagnostic value. Our study aimed to assess the prevalence of microscopic esophageal lesions as defined by the Esohisto consensus guidelines, which have proven high interobserver agreement in previous studies. In the prospective Central European multicenter histoGERD trial, we recruited 1071 individuals (576 females and 495 males; median age, 53 years; range, 15-93 years) undergoing gastroscopy for nonselected reasons. Biopsy material was systematically sampled from above and below the gastroesophageal junction. Overall, histologic diagnosis of mild and severe esophagitis was made in 423 (39.5%) and 296 (27.6%) individuals, respectively, whereas the squamous mucosa of 352 individuals (32.9%) was normal upon histology or showed only insignificant findings. Proliferative changes of the squamous epithelium, in particular basal cell layer hyperplasia, papillary elongation, and intercellular space dilation, were more common than inflammatory cell infiltration. The presence of microscopic esophagitis was associated with male sex (P = .009), patients' symptoms (P = .003), history of proton pump inhibitor intake (P < .001), and the endoscopic diagnosis of esophagitis (P < .001). Notably, among the 450 patients with no endoscopic signs of esophagitis (Los Angeles Category N), 41.8% and 17.1% were identified with mild and severe (microscopic) esophagitis, respectively, indicating higher sensitivity of histologic diagnosis. In conclusion, our data illustrate the value of histology in the workup of patients with reflux disease. We suggest that biopsies should routinely be obtained when patients undergo upper gastrointestinal endoscopy for evaluation of GERD and may particularly be beneficial in patients with nonerosive reflux disease. Copyright © 2014 Elsevier Inc. All rights reserved.
- Find related publications in this database (using NLM MeSH Indexing)
- Adolescent -
- Adult -
- Aged -
- Aged, 80 and over -
- Biopsy -
- Epithelium - pathology
- Esophagitis - diagnosis Esophagitis - pathology
- Esophagogastric Junction - pathology
- Esophagoscopy -
- Esophagus - pathology
- Female -
- Gastroesophageal Reflux - diagnosis Gastroesophageal Reflux - epidemiology Gastroesophageal Reflux - pathology
- Humans -
- Male -
- Middle Aged -
- Practice Guidelines as Topic -
- Prevalence -
- Proton Pump Inhibitors - therapeutic use
- Stomach - pathology
- Find related publications in this database (Keywords)
- Gastroesophageal junction
- Gastroesophageal reflux disease
- Reflux
- Esophagitis
- Los Angeles classification
- Histology
- Pathology