关于胃肠道症状与内镜活检诊断移植对宿主疾病的部位之间的相关性
Carlos Figueredo1, Melissa Fazzari2, Lawrence J Brandt1
1Division of Gastroenterology and Hepatology, Montefiore Medical Center, Bronx, New York, USA.
Clinical and translational gastroenterology
|November 21, 2025
概括
通过将内镜活检与患者症状对齐,改善了胃肠道移植与宿主疾病 (GI-GVHD) 的诊断. 以症状为导向的方法提高了诊断准确性,并可以降低成本,特别是在使用灵活的西格米多斯科普来治疗下部肠道症状时.
科学领域:
- 胃肠病学 胃肠病学
- 血液学 血液学 血液学
- 在瘤学瘤学.
背景情况:
- 胃肠道移植对宿主疾病 (GI-GVHD) 是血液造血干细胞移植后的一种严重并发症.
- 目前的诊断依赖于内镜活检,但基于症状的最佳策略尚未明确.
研究的目的:
- 在怀疑GI-GVHD的患者中,评估症状指导内镜活检的诊断准确性.
- 确定上部 (UGI) 和下部 (LGI) 胃肠道症状与活检证明的GI-GVHD之间的相关性.
主要方法:
- 75名成年造血干细胞移植接受者进行了回顾性队列研究,他们有胃肠道症状和GVHD.
- 使用统计方法 (包括后勤回归) 分析UGI/LGI症状和活检结果之间的相关性.
- 亚组分析,比较灵活的西格莫显微镜与LGI症状的全结肠镜的诊断产量.
主要成果:
- 活检阳性与症状位置有很强的相关性:UGI症状为89.5%,LGI症状为100%.
- 症状位置是活检结果的独立预测因素 (P < 0.001).
- 脊柱体细胞活检显示LGI症状的完美相关性 (r=1.0),这表明灵活的西格米多斯科皮是有效的.
结论:
- 以症状为导向的内镜评估表明GI-GVHD的高诊断准确性.
- 灵活的sigmoidoscopy与有针对性的活检是一个成本效益和准确的选择LGI症状.
- 解剖学向的内镜方法可以改善患者护理和GI-GVHD管理中的资源利用.
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