دورية أكاديمية
Confocal laser endomicroscopy for the differential diagnosis of ulcerative colitis and Crohn's disease: a pilot study.
| العنوان: | Confocal laser endomicroscopy for the differential diagnosis of ulcerative colitis and Crohn's disease: a pilot study. |
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| المؤلفون: | Tontini GE; Department of Medicine, University of Erlangen-Nuremberg, Erlangen, Germany., Mudter J; Department of Medicine, University of Erlangen-Nuremberg, Erlangen, Germany., Vieth M; Institute of Pathology, Klinikum Bayreuth, Bayreuth, Germany., Atreya R; Department of Medicine, University of Erlangen-Nuremberg, Erlangen, Germany., Günther C; Department of Medicine, University of Erlangen-Nuremberg, Erlangen, Germany., Zopf Y; Department of Medicine, University of Erlangen-Nuremberg, Erlangen, Germany., Wildner D; Department of Medicine, University of Erlangen-Nuremberg, Erlangen, Germany., Kiesslich R; St. Marienkrankenhaus Katharina-Kasper, Frankfurt am Main, Germany., Vecchi M; Gastroenterology and Digestive Endoscopy Unit, IRCCS Policlinico San Donato, San Donato Milanese, Italy., Neurath MF; Department of Medicine, University of Erlangen-Nuremberg, Erlangen, Germany., Neumann H; Department of Medicine, University of Erlangen-Nuremberg, Erlangen, Germany. |
| المصدر: | Endoscopy [Endoscopy] 2015 May; Vol. 47 (5), pp. 437-43. Date of Electronic Publication: 2014 Dec 18. |
| نوع المنشور: | Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't |
| اللغة: | English |
| بيانات الدورية: | Publisher: Georg Thieme Verlag Country of Publication: Germany NLM ID: 0215166 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1438-8812 (Electronic) Linking ISSN: 0013726X NLM ISO Abbreviation: Endoscopy Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: Stuttgart : Georg Thieme Verlag Original Publication: Stuttgart, Thieme. |
| مواضيع طبية MeSH: | Colitis, Ulcerative/*pathology , Crohn Disease/*pathology , Intestinal Mucosa/*pathology, Adolescent ; Adult ; Aged ; Colonoscopy ; Diagnosis, Differential ; Female ; Fluorescein ; Fluorescent Dyes ; Humans ; Male ; Microscopy, Confocal/methods ; Middle Aged ; Pilot Projects ; Prospective Studies ; Young Adult |
| مستخلص: | Background and Study Aim: The differential diagnosis of ulcerative colitis from Crohn's disease is of pivotal importance for the management of inflammatory bowel diseases, as both entities involve specific therapeutic management strategies. Confocal laser endomicroscopy (CLE) allows on-demand, in vivo characterization of architectural and cellular details during endoscopy. The aim of this study was to assess the efficacy of CLE to differentiate between ulcerative colitis and Crohn's disease. Patients and Methods: This was a prospective study involving consecutive patients with a well-established diagnosis of ulcerative colitis or Crohn's disease who underwent colonoscopy with fluorescein-aided confocal imaging. Results: Overall, 79 patients were included (40 Crohn's disease, 39 ulcerative colitis). CLE findings in patients with Crohn's disease, showed significantly more discontinuous inflammation (87.5 % vs. 5.1 %), focal cryptitis (75.0 % vs. 12.8 %), and discontinuous crypt architectural abnormality (87.5 % vs. 10.3 %) than in ulcerative colitis (P < 0.0001). Conversely, ulcerative colitis was associated with severe, widespread crypt distortion (87.2 % vs. 17.5 % in Crohn's disease), decreased crypt density (79.5 % vs. 22.5 %), and frankly irregular surface (89.7 % vs. 17.5 %; P < 0.0001 for all comparisons). Statistically significant differences were not seen for heavy, diffuse lamina propria cell increase or mucin preservation. No granulomas were visible. Based on these findings, a CLE scoring system was developed that revealed excellent accuracy (93.7 %) when compared with the historical clinical diagnosis and the histopathological gold standard. Conclusions: CLE could visualize several disease-specific microscopic features, which are conventionally used in standard histopathology to differentiate between ulcerative colitis and Crohn's disease. However, because of the limited penetration depth of CLE, submucosal details or granulomas were not visible. The new scoring system may allow in vivo diagnosis of ulcerative colitis or Crohn's disease. Trial registered at ClinicalTrials.gov: NCT 02238665. (© Georg Thieme Verlag KG Stuttgart · New York.) |
| التعليقات: | Comment in: Endoscopy. 2015 May;47(5):v8. (PMID: 25910019) Comment in: Endoscopy. 2015 May;47(5):477. (PMID: 26106760) |
| سلسلة جزيئية: | ClinicalTrials.gov NCT02238665 |
| المشرفين على المادة: | 0 (Fluorescent Dyes) TPY09G7XIR (Fluorescein) |
| تواريخ الأحداث: | Date Created: 20141219 Date Completed: 20160218 Latest Revision: 20150427 |
| رمز التحديث: | 20240628 |
| DOI: | 10.1055/s-0034-1391226 |
| PMID: | 25521573 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 1438-8812 |
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| DOI: | 10.1055/s-0034-1391226 |