PDF(Pubmed)
Abstract：
BACKGROUND: Eosinophilic esophagitis (EoE) is an immune-mediated esophageal disease with rising incidence. While proton pump inhibitors (PPIs) are the first-line treatment, a significant proportion of patients do not respond. This study aimed to determine if the EoE Histology Scoring System (EoEHSS) can predict PPI responsiveness.
METHODS: A cross-sectional study was conducted on 89 pediatric patients diagnosed with EoE between 2016 and 2022. Patients were categorized into PPI responders (PPIREoE) and non-responders (PPINREoE) based on post-treatment biopsies. EoEHSS values from biopsies of the esophagus (distal, middle, and proximal segments) were compared between the two groups.
RESULTS: No significant differences in EoEHSS scores were observed for the distal and proximal esophagus between the groups. However, the middle esophagus showed a significantly higher EoEHSS grade score in the PPINREoE group, indicating a more pronounced disease severity. Specific histological features, particularly eosinophilic abscesses and surface layering of the middle segment of the esophagus, were significantly different between the groups.
CONCLUSIONS: Performing a biopsy of each esophageal segment, particularly the middle, is crucial for diagnostic precision and predicting PPI responsiveness. The EoEHSS can serve as a valuable tool in predicting therapy response, emphasizing the need for personalized therapeutic approaches in EoE management.
METHODS: A cross-sectional study was conducted on 89 pediatric patients diagnosed with EoE between 2016 and 2022. Patients were categorized into PPI responders (PPIREoE) and non-responders (PPINREoE) based on post-treatment biopsies. EoEHSS values from biopsies of the esophagus (distal, middle, and proximal segments) were compared between the two groups.
RESULTS: No significant differences in EoEHSS scores were observed for the distal and proximal esophagus between the groups. However, the middle esophagus showed a significantly higher EoEHSS grade score in the PPINREoE group, indicating a more pronounced disease severity. Specific histological features, particularly eosinophilic abscesses and surface layering of the middle segment of the esophagus, were significantly different between the groups.
CONCLUSIONS: Performing a biopsy of each esophageal segment, particularly the middle, is crucial for diagnostic precision and predicting PPI responsiveness. The EoEHSS can serve as a valuable tool in predicting therapy response, emphasizing the need for personalized therapeutic approaches in EoE management.
摘要：
背景：嗜酸细胞性食管炎（EoE）是一种免疫介导的食管疾病，发病率不断上升。虽然质子泵抑制剂（PPI）是一线治疗，相当比例的患者没有反应。这项研究旨在确定EoE组织学评分系统（EoEHSS）是否可以预测PPI反应性。
方法：对2016年至2022年诊断为EoE的89例儿科患者进行了横断面研究。根据治疗后活检，将患者分为PPI反应者（PPIREoE）和非反应者（PPINREoE）。来自食道活检的EoEHSS值（远端，中间,和近端节段)进行比较。
结果：两组间远端和近端食管的EoEHSS评分无显著差异。然而,PPINREoE组食管中段EoEHSS评分明显增高,表明疾病严重程度更明显。特定的组织学特征，特别是食管中段的嗜酸性脓肿和表面分层，组间差异显著。
结论：对每个食管段进行活检，尤其是中间,对于诊断精度和预测PPI反应性至关重要。EoEHSS可以作为预测治疗反应的有价值的工具，强调在EoE管理中需要个性化的治疗方法。
方法：对2016年至2022年诊断为EoE的89例儿科患者进行了横断面研究。根据治疗后活检，将患者分为PPI反应者（PPIREoE）和非反应者（PPINREoE）。来自食道活检的EoEHSS值（远端，中间,和近端节段)进行比较。
结果：两组间远端和近端食管的EoEHSS评分无显著差异。然而,PPINREoE组食管中段EoEHSS评分明显增高,表明疾病严重程度更明显。特定的组织学特征，特别是食管中段的嗜酸性脓肿和表面分层，组间差异显著。
结论：对每个食管段进行活检，尤其是中间,对于诊断精度和预测PPI反应性至关重要。EoEHSS可以作为预测治疗反应的有价值的工具，强调在EoE管理中需要个性化的治疗方法。
