ROC-king onwards: intraepithelial lymphocyte counts, distribution & role in coeliac disease mucosal interpretation.
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Ошибки и ограничения
История · было → стало
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Rostami Kamran, Marsh Michael N, Johnson Matt W, Mohaghegh Hamid, Heal Calvin, Holmes Geoffrey, Ensari Arzu, Aldulaimi David, Bancel Brigitte, Bassotti Gabrio, Bateman Adrian, Becheanu Gabriel, Bozzola Anna, Carroccio Antonio, Catassi Carlo, Ciacci Carolina, Ciobanu Alexandra, Danciu Mihai, Derakhshan Mohammad H, Elli Luca, Ferrero Stefano, Fiorentino Michelangelo, Fiorino Marilena, Ganji Azita, Ghaffarzadehgan Kamran, Going James J, Ishaq Sauid, Mandolesi Alessandra, Mathews Sherly, Maxim Roxana, Mulder Chris J, Neefjes-Borst Andra, Robert Marie, Russo Ilaria, Rostami-Nejad Mohammad, Sidoni Angelo, Sotoudeh Masoud, Villanacci Vincenzo, Volta Umberto, Zali Mohammad R, Srivastava Amitabh
Аннотация
DESIGN: The study was designed at the International Meeting on Digestive Pathology, Bucharest 2015. Investigators from 19 centres, eight countries of three continents, recruited 198 patients with Marsh III histology and 203 controls and used one agreed protocol to count IEL/100 enterocytes in well-oriented duodenal biopsies. Demographic and serological data were also collected.
RESULTS: The mean ages of CD and control groups were 45.5 (neonate to 82) and 38.3 (2-88) years. Mean IEL count was 54±18/100 enterocytes in CD and 13±8 in normal controls (p=0.0001). ROC analysis indicated an optimal cut-off point of 25 IEL/100 enterocytes, with 99% sensitivity, 92% specificity and 99.5% area under the curve. Other cut-offs between 20 and 40 IEL were less discriminatory. Additionally, there was a sufficiently high number of biopsies to explore IEL counts across the subclassification of the Marsh III lesion.
CONCLUSION: Our ROC curve analyses demonstrate that for Marsh III lesions, a cut-off of 25 IEL/100 enterocytes optimises discrimination between normal control and CD biopsies. No differences in IEL counts were found between Marsh III a, b and c lesions. There was an indication of a continuously graded dose-response by IEL to environmental (gluten) antigenic influence.