The Yield of Routine Tissue Sampling in Pediatric Gastrointestinal Endoscopy.
Journal
Journal of pediatric gastroenterology and nutrition
ISSN: 1536-4801
Titre abrégé: J Pediatr Gastroenterol Nutr
Pays: United States
ID NLM: 8211545
Informations de publication
Date de publication:
01 04 2023
01 04 2023
Historique:
pubmed:
24
1
2023
medline:
25
3
2023
entrez:
23
1
2023
Statut:
ppublish
Résumé
Societies' guidelines suggest routine tissue sampling in all children undergoing esophagogastroduodenoscopy and ileocolonoscopy, even in the absence of visible endoscopy abnormalities. We aimed to determine the agreement between endoscopic and histopathological findings in pediatric endoscopy and to assess the yield of routine biopsies from all sites. Since January 2019, our endoscopy institute protocol has included routine biopsies sampling from the esophagus, stomach, duodenum, ileum, and colon in all diagnostic procedures. Agreement between tests was done using the kappa coefficient ( κ ). The study included all endoscopies performed during 2019. In total, 541 diagnostic endoscopies were done during the study period with 434 (80%) esophagogastroduodenoscopy and 107 (20%) were ileocolonoscopy. Compared to histology, endoscopic findings performance were: esophagus-sensitivity 33%, specificity 98%; stomach-sensitivity 60%, specificity 89%; duodenum-sensitivity 50%, specificity 97%; duodenal bulb-sensitivity 47%, specificity 89%; terminal ileum-sensitivity 82%, specificity 100%; colon-sensitivity 84%, specificity 96%. Assessment of concordance between endoscopic and histopathologic findings reveals an overall low level of agreement in esophagogastroduodenoscopy ( κ of 0.39, 0.51, 0.53, and 0.24 for the esophagus, stomach, duodenal second part, and bulb, respectively), and good agreement in ileocolonoscopy ( κ of 0.88 and 0.81 for the ileum and colon, respectively). Endoscopy findings are highly specific for histologic pathology, whereas the absence of findings correlates poorly with histologic findings. Ileocolonoscopy shows better agreement than esophagogastroduodenoscopy. Our data support routine tissue sampling in pediatric endoscopy.
Identifiants
pubmed: 36689933
doi: 10.1097/MPG.0000000000003710
pii: 00005176-202304000-00019
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
489-493Informations de copyright
Copyright © 2023 by European Society for European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition.
Déclaration de conflit d'intérêts
The authors report no conflicts of interest.
Références
Thomson M, Tringali A, Landi R, et al. Pediatric gastrointestinal endoscopy: European Society of Pediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) and European Society of Gastrointestinal Endoscopy (ESGE) Guidelines. J Pediatr Gastroenterol Nutr 2017;64:133–53.
Oliva S, Thomson M, de Ridder L, et al. Endoscopy in pediatric inflammatory bowel disease: a position paper on behalf of the Porto IBD Group of the European Society for Pediatric Gastroenterology, Hepatology and Nutrition. J Pediatr Gastroenterol Nutr 2018;67:414–30.
Sheiko MA, Feinstein JA, Capocelli KE, Kramer RE. The concordance of endoscopic and histologic findings of 1000 pediatric EGDs. Gastrointest Endosc 2015;81:1385–91.
Kori M, Gladish V, Ziv-Sokolovskaya N, Huszar M, Beer-Gabel M, Reifen R. The significance of routine duodenal biopsies in pediatric patients undergoing upper intestinal endoscopy. J Clin Gastroenterol 2003;37:39–41.
Dahshan A, Rabah R. Correlation of endoscopy and histology in the gastroesophageal mucosa in children: are routine biopsies justified? J Clin Gastroenterol 2000;31:213–6.
Scomparin RC, Lourencao PLTA, Comes GT, et al. Are biopsies always necessary in upper and lower gastrointestinal endoscopy in children? A retrospective 10-year analysis. Eur J Pediatr 2021;180:1089–98.
Manfredi MA, Jiang H, Borges LF, Deutsch AJ, Goldsmith JD, Lightdale JR. Good agreement between endoscopic findings and biopsy reports supports limited tissue sampling during pediatric colonoscopy. J Pediatr Gastroenterol Nutr 2014;58:773–8.
Glass J, Alcala HE, Tobin M. The value of obtaining colonic mucosal biopsies of grossly normal tissue in pediatric patients. J Pediatr Gastroenterol Nutr 2021;72:677–82.
Badizadegan K, Thompson KM. Value of information in nonfocal colonic biopsies. J Pediatr Gastroenterol Nutr 2011;53:679–83.
Husby S, Koletzko S, Korponay-Szabó I, et al. European Society Paediatric Gastroenterology, Hepatology and Nutrition guidelines for diagnosing coeliac disease 2020. J Pediatr Gastroenterol Nutr 2020;70:141–56.
Tytgat GN. Role of endoscopy and biopsy in the work up of dyspepsia. Gut 2002;50(suppl 4):iv13–6.
Polydorides AD. Pathology and differential diagnosis of chronic, noninfectious gastritis. Semin Diagn Pathol 2014;31:114–23 [published correction appears in Semin Diagn Pathol. 2014 Jul;31(4):314–7].
Liu X, Xiao SY, Plesec TP, Jiang W, Goldblum JR, Lazenby AJ. Collagenous colitis in children and adolescents: study of 7 cases and literature review. Mod Pathol 2013;26:881–7.
Singh P, Das P, Jain AK, et al. Microscopic colitis in children with chronic diarrhea. J Pediatr Gastroenterol Nutr 2013;57:240–4.