Gabriella Canavese1, Vincenzo Villanacci2, Anna Sapino3, Rodolfo Rocca4, Marco Daperno4, Renzo Suriani4, Francesca Maletta3, Paola Cassoni3. 1. Pathology Department, Azienda Ospedaliera Città della Salute e della Scienza di Torino, Turin, Italy. Electronic address: gcanavese@cittadellasalute.to.it. 2. Pathology Department, Spedali Civili di Brescia, Brescia, Italy. 3. Department of Medical Sciences, University of Turin, Turin, Italy. 4. Gastroenterology Department, Ospedale Mauriziano, Turin, Italy.
Abstract
BACKGROUND: The diagnosis of inflammatory bowel disease can be challenging and requires the efforts of a multidisciplinary team. We performed a retrospective analysis with the aim of evaluating the adequacy of the prerequisites for arriving at an accurate histological diagnosis. METHODS: The following parameters were considered as prerequisites for a diagnosis of inflammatory bowel disease: clinical and endoscopic data; proper sampling and handling of biopsies; and elementary microscopic lesions. We collected 345 cases from 13 centres. RESULTS: The date of onset and treatment were available for 13% and 16% of the cases, respectively. Endoscopy information was accessible for 77% of the cases. Endoscopic mapping was completed in 13% of the cases. In no cases were the biopsies oriented on acetate strips. The diagnosis was conclusive in 47% of the cases. Activity, epithelial disruption and crypt distortion were described in 35% of the reports with a conclusive diagnosis. CONCLUSION: Our study showed that the diagnostic prerequisites were widely unfulfilled, although approximately half of the diagnoses were conclusive for inflammatory bowel disease. Thus, in our assessment of clinical practice: (1) clinicians seldom provide suitable clinical and/or endoscopic information for a histological diagnosis and (2) histopathological diagnoses of inflammatory bowel disease are often not supported by morphology.
BACKGROUND: The diagnosis of inflammatory bowel disease can be challenging and requires the efforts of a multidisciplinary team. We performed a retrospective analysis with the aim of evaluating the adequacy of the prerequisites for arriving at an accurate histological diagnosis. METHODS: The following parameters were considered as prerequisites for a diagnosis of inflammatory bowel disease: clinical and endoscopic data; proper sampling and handling of biopsies; and elementary microscopic lesions. We collected 345 cases from 13 centres. RESULTS: The date of onset and treatment were available for 13% and 16% of the cases, respectively. Endoscopy information was accessible for 77% of the cases. Endoscopic mapping was completed in 13% of the cases. In no cases were the biopsies oriented on acetate strips. The diagnosis was conclusive in 47% of the cases. Activity, epithelial disruption and crypt distortion were described in 35% of the reports with a conclusive diagnosis. CONCLUSION: Our study showed that the diagnostic prerequisites were widely unfulfilled, although approximately half of the diagnoses were conclusive for inflammatory bowel disease. Thus, in our assessment of clinical practice: (1) clinicians seldom provide suitable clinical and/or endoscopic information for a histological diagnosis and (2) histopathological diagnoses of inflammatory bowel disease are often not supported by morphology.
Authors: HyunTaek Jung; Jae Seok Kim; Keum Hwa Lee; Kalthoum Tizaoui; Salvatore Terrazzino; Sarah Cargnin; Lee Smith; Ai Koyanagi; Louis Jacob; Han Li; Sung Hwi Hong; Dong Keon Yon; Seung Won Lee; Min Seo Kim; Paul Wasuwanich; Wikrom Karnsakul; Jae Il Shin; Andreas Kronbichler Journal: Int J Biol Sci Date: 2021-05-17 Impact factor: 6.580