Computer card morphometry of jejunal biopsies in childhood coeliac disease.

Meinhard, E; Wadbrook, D. G.; Risdon, R. A.

doi:10.1136/jcp.28.2.85

Cited by 20 publications

(10 citation statements)

References 18 publications

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“…Although the Q-histology was introduced in the 1970s, their use, however, remained limited to the research settings only [11]. Even with this limited use, the Q-histology assessment technique evolved over a period of time and became more straightforward from older methods of measuring the mucosal surface to volume ratio, mucosal index (mucosal height to length of muscularis mucosa) assessment [12] and computer card based drawing technique [8] to a more simplified recent protocol of using the villous height (Vh) to crypt depth (Cd) ratio [9]. However, despite its acceptance and simplification, Q-histology has yet not become the standard for clinical care.…”

Section: Introductionmentioning

confidence: 99%

Quantitative histology-based classification system for assessment of the intestinal mucosal histological changes in patients with celiac disease

et al. 2019

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Background/Aims The existing histological classifications for the interpretation of small intestinal biopsies are based on qualitative parameters with high intraobserver and interobserver variations. We have developed and propose a quantitative histological classification system for the assessment of intestinal mucosal biopsies. Methods We performed a computer-assisted quantitative histological assessment of digital images of duodenal biopsies from 137 controls and 124 patients with celiac disease (CeD) (derivation cohort). From the receiver-operating curve analysis, followed by multivariate and logistic regression analyses, we identified parameters for differentiating control biopsies from those of the patients with CeD. We repeated the quantitative histological analysis in a validation cohort (105 controls and 120 patients with CeD). On the basis of the results, we propose a quantitative histological classification system. The new classification was compared with the existing histological classifications for interobserver and intraobserver agreements by a group of qualified pathologists. Results Among the histological parameters, intraepithelial lymphocyte count of ≥25/100 epithelial cells, adjusted villous height fold change of ≤0.7, and crypt depth-to-villous height ratio of ≥0.5 showed good discriminative power between the mucosal biopsies from the patients with CeD and those from the controls, with 90.3% sensitivity, 93.5% specificity, and 96.2% area under the curve. Among the existing histological classifications, our quantitative histological classification showed the highest intraobserver (69.7%–85.03%) and interobserver (24.6%–71.5%) agreements. Conclusions Quantitative assessment increases the reliability of the histological assessment of mucosal biopsies in patients with CeD. Such a classification system may be used for clinical trials in patients with CeD.

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Section: Introductionmentioning

confidence: 99%

Quantitative histology-based classification system for assessment of the intestinal mucosal histological changes in patients with celiac disease

et al. 2019

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“…Furthermore, since the spatial arrangement of the point counts are retained, the measured image can, in effect, be reconstructed within the computer. It is in fact possible to produce pictorial as well as numerical printouts from the data suitable for inclusion in the patients' notes (Meinhard et al, 1975). Since the matrix is calibrated, volume and surface area determinations can be derived in absolute terms.…”

Section: Discussionmentioning

confidence: 99%

“…Method 2 (Meinhard et al, 1975) The method requires the tracing of a correctly orientated microscopic image of the biopsy on to computer data cards; the grids printed on the cards provide a point counting graticule of 840 sampling points.…”

Section: Morphometrymentioning

confidence: 99%

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Small intestinal biopsy in childhood coeliac disease

Risdon

Wadbrook

Meinhard

et al. 1975

Postgraduate Medical Journal

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Summary Small intestinal biopsies from children with treated and untreated coeliac disease have been analysed morphometrically and compared with controls. Two methods have been used; one, described by Dunnill and Whitehead (1972) provides indices of surface-to-volume ratio and of mucosal volume. The other, described by Meinhard, Wadbrook and Risdon (1965), involves tracing the microscopic image of the biopsy on to computer data cards to produce measured encoded data for direct analysis with a computer. Biopsies from untreated coeliacs were clearly distinguished from control specimens by both techniques. Comparison of these two groups by computer card morphometry shows the mucosal lesion in coeliac disease to be associated with a spatial redistribution of the tissue components rather than a change in their absolute amounts. No difference in the total mucosal volume was found so that a true mucosal atrophy does not occur in this condition. Surface-to-volume (c: lh) ratios were measured in twenty-eight children treated empirically with a gluten-free diet for suspected coeliac disease, in biopsies taken before and after a gluten challenge. By this means the diagnosis of coeliac disease was confirmed in eighteen of these patients. In morphologically normal biopsies correlation of c: lh ratios with age showed significantly smaller values in younger children. Slight changes in biopsies from young children should, therefore, be interpreted cautiously and should not necessarily be regarded as pathological on the evidence of the villous pattern alone.

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“…Morphometric techniques [9,26,31,32,43] were used, intraepithelial lymphocyte counts [4] determined, and double-stain immunofluorescent histology was done, based on quantitative evaluation of defined mucosal tissue units [2,37], to compare differences. Stepwise discriminant analysis of the variables was carried out [271.…”

Section: Introductionmentioning

confidence: 99%

Small intestinal mucosa in coeliac disease and cow's milk protein intolerance: Morphometric and immunofluorescent studies

1982

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One hundred and twenty-five small intestinal biopsies from children with coeliac disease (CD), cow's milk protein intolerance (CMPI) and controls were compared by morphometric analysis, by counting intraepithelial lymphocytes (IEL) and by quantitative evaluation of immunoglobulin-containing cells of lamina propria. The double-stain immunofluorescent technique of Brandtzaeg and Baklien [2] was used, based on defined mucosal tissue units. A patchy enteropathy was found in 60% of CMPI, and in 14% of nonspecific changes, but never in CD. There was a significant difference in crypt depth between CD (360 +/- 80 microns) and CMPI (217 +/- 92 microns), even when lesions of equal grade were compared (P less than 0.015). IEL counts per 1000 epithelial cells showed even better discrimination between the groups (CD: 793 +/- 173, CMPI: 320 +/- 143, P less than 0.001). In CD, there was a relatively greater increase of IgM-cells (X 4.9) and of IgG-cells (X 4.2) than of IgA-cells (X 2.6). Ig-cell changes outlasted the morphological lesion in CD on a gluten-free diet. In CMPI, IgM-cells (X 2.3), IgG-cells (X 2.5), and IgA-cells (X 1.7) were proportionately increased, compared to controls. A special increase of IgE-cells in CMPI could not be substantiated. By computerized stepwise discriminant analysis based upon crypt depth, villus/crypt-ratio, IEL-count, and counts of IgM-, IgG-, IgA-containing cells of lamina propria, accurate classification of patient groups was accomplished, even when only the initial biopsy data were analysed.

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Computer card morphometry of jejunal biopsies in childhood coeliac disease.

Cited by 20 publications

References 18 publications

Quantitative histology-based classification system for assessment of the intestinal mucosal histological changes in patients with celiac disease

Quantitative histology-based classification system for assessment of the intestinal mucosal histological changes in patients with celiac disease

Small intestinal biopsy in childhood coeliac disease

Small intestinal mucosa in coeliac disease and cow's milk protein intolerance: Morphometric and immunofluorescent studies

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