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Accuracy of identification of tissue types in endoscopic esophageal mucosal biopsies used for molecular biology studies.

Beck P, Mayne GC, Astill D, Irvine T, Watson DI, Dijckmeester WA, Wijnhoven BP, Hussey DJ - Clin Exp Gastroenterol (2009)

Bottom Line: On 59 (70.2%) metaplastic columnar-lined epithelium levels and on 62 (46%) columnar-lined epithelium with intestinal metaplasia levels, tissue heterogeneity was observed in clinical histopathology, with portions of squamous epithelium within the samples.Matches with pure tissue samples in both clinical and research histopathology levels were observed on 22 (26.2%) levels of metaplastic columnar-lined epithelium and in 55 (40.7%) levels of columnar-lined epithelium with intestinal metaplasia.The high proportion of mismatches and tissue heterogeneity observed, especially among columnar-lined epithelium with intestinal metaplasia and dysplasia, points to the necessity of determining the histopathology of the research samples to avoid sampling errors during molecular studies.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery.

ABSTRACT

Objectives: To determine if histopathologic assessment of esophageal biopsies harvested for research study is justified due to the heterogeneity of tissues in the esophagus, and the consequent histopathologic mis-matches with the clinical histopathology of biopsies taken at the same level.

Methods: Since 2004, patients undergoing upper endoscopy for a variety of clinical conditions were invited to provide additional esophageal biopsies; those were collected for research purpose at the same level as biopsies collected for clinical histopathology. Research biopsies were cut in two parts: one part was submitted to research histopathology and the other stored for molecular analysis. Results of clinical histopathology for each patient were summarized per biopsy level and compared to results obtained from research biopsies at the corresponding level.

Results: A total of 377 level summaries were obtained from 137 patients. Clinical histopathology summaries classified 123 levels (32.6%) as squamous epithelium, 84 levels (22.3%) as metaplastic columnar-lined epithelium, 135 levels (35.8%) as columnar-lined epithelium with intestinal metaplasia, 30 levels (8%) as dysplasia, and 5 levels (1.3%) as adenocarcinoma. Research histopathology matched to clinical summaries on 120 of 123 (97.5%) levels for squamous epithelium, 52 of 84 (61.9%) for metaplastic columnar-lined epithelium, and 94 of 135 (69.5%) for columnar-lined epithelium with intestinal metaplasia. There were no matches for dysplasia between the groups; however, they agreed on all five cases of AC. On 59 (70.2%) metaplastic columnar-lined epithelium levels and on 62 (46%) columnar-lined epithelium with intestinal metaplasia levels, tissue heterogeneity was observed in clinical histopathology, with portions of squamous epithelium within the samples. Matches with pure tissue samples in both clinical and research histopathology levels were observed on 22 (26.2%) levels of metaplastic columnar-lined epithelium and in 55 (40.7%) levels of columnar-lined epithelium with intestinal metaplasia.

Conclusions: The high proportion of mismatches and tissue heterogeneity observed, especially among columnar-lined epithelium with intestinal metaplasia and dysplasia, points to the necessity of determining the histopathology of the research samples to avoid sampling errors during molecular studies.

No MeSH data available.


Related in: MedlinePlus

Number of matches and mismatches between histopathology for research biopsy vs. clinical biopsy. The type of tissue present in the clinical biopsy is named on the X axis.Notes: The number of biopsies for which there was a perfect match between clinical and research histopathology is shown above the ‘matches’ column. The number of biopsies for which there was a partial mis-match (ie, some degree of heterogeneity of tissue types) or a complete mismatch (ie, no commonality in tissue types) between clinical and research histopathology is shown above the ‘mismatches’ column.Abbreviations: AC, adenocarcinoma; CLE, columnar-lined epithelium; D, dysplasia; IM, columnar-lined epithelium with intestinal metaplasia; SE, squamous epithelium.
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f2-ceg-2-001: Number of matches and mismatches between histopathology for research biopsy vs. clinical biopsy. The type of tissue present in the clinical biopsy is named on the X axis.Notes: The number of biopsies for which there was a perfect match between clinical and research histopathology is shown above the ‘matches’ column. The number of biopsies for which there was a partial mis-match (ie, some degree of heterogeneity of tissue types) or a complete mismatch (ie, no commonality in tissue types) between clinical and research histopathology is shown above the ‘mismatches’ column.Abbreviations: AC, adenocarcinoma; CLE, columnar-lined epithelium; D, dysplasia; IM, columnar-lined epithelium with intestinal metaplasia; SE, squamous epithelium.

Mentions: Two hundred seventy-one (71.9 %) of the diagnoses made by histopathology assessment of the research biopsy fragments, matched the clinical histopathology assessment, and in 108 (28.1%) the assessment differed (Figure 2). The proportion of matches between assessment from corresponding research and clinical biopsies varied according to the pathological classification. There was a high level of concordance for squamous epithelium and adenocarcinoma, with all but three squamous epithelium and all adenocarcinoma research biopsies matching the classification of adjacent clinical samples. However, the tissue type identified in the clinical biopsies matched the type identified in the research biopsy fragments in only 52 of 84 (61.9%) columnar epithelium without intestinal metaplasia samples, and 94 of 135 (69.6%) the columnar epithelium with intestinal metaplasia samples (Figure 2). Differences usually occurred when columnar epithelium without intestinal metaplasia was identified in one sample, and columnar epithelium with intestinal metaplasia in the matched samples, and vice versa.


Accuracy of identification of tissue types in endoscopic esophageal mucosal biopsies used for molecular biology studies.

Beck P, Mayne GC, Astill D, Irvine T, Watson DI, Dijckmeester WA, Wijnhoven BP, Hussey DJ - Clin Exp Gastroenterol (2009)

Number of matches and mismatches between histopathology for research biopsy vs. clinical biopsy. The type of tissue present in the clinical biopsy is named on the X axis.Notes: The number of biopsies for which there was a perfect match between clinical and research histopathology is shown above the ‘matches’ column. The number of biopsies for which there was a partial mis-match (ie, some degree of heterogeneity of tissue types) or a complete mismatch (ie, no commonality in tissue types) between clinical and research histopathology is shown above the ‘mismatches’ column.Abbreviations: AC, adenocarcinoma; CLE, columnar-lined epithelium; D, dysplasia; IM, columnar-lined epithelium with intestinal metaplasia; SE, squamous epithelium.
© Copyright Policy
Related In: Results  -  Collection

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getmorefigures.php?uid=PMC3108633&req=5

f2-ceg-2-001: Number of matches and mismatches between histopathology for research biopsy vs. clinical biopsy. The type of tissue present in the clinical biopsy is named on the X axis.Notes: The number of biopsies for which there was a perfect match between clinical and research histopathology is shown above the ‘matches’ column. The number of biopsies for which there was a partial mis-match (ie, some degree of heterogeneity of tissue types) or a complete mismatch (ie, no commonality in tissue types) between clinical and research histopathology is shown above the ‘mismatches’ column.Abbreviations: AC, adenocarcinoma; CLE, columnar-lined epithelium; D, dysplasia; IM, columnar-lined epithelium with intestinal metaplasia; SE, squamous epithelium.
Mentions: Two hundred seventy-one (71.9 %) of the diagnoses made by histopathology assessment of the research biopsy fragments, matched the clinical histopathology assessment, and in 108 (28.1%) the assessment differed (Figure 2). The proportion of matches between assessment from corresponding research and clinical biopsies varied according to the pathological classification. There was a high level of concordance for squamous epithelium and adenocarcinoma, with all but three squamous epithelium and all adenocarcinoma research biopsies matching the classification of adjacent clinical samples. However, the tissue type identified in the clinical biopsies matched the type identified in the research biopsy fragments in only 52 of 84 (61.9%) columnar epithelium without intestinal metaplasia samples, and 94 of 135 (69.6%) the columnar epithelium with intestinal metaplasia samples (Figure 2). Differences usually occurred when columnar epithelium without intestinal metaplasia was identified in one sample, and columnar epithelium with intestinal metaplasia in the matched samples, and vice versa.

Bottom Line: On 59 (70.2%) metaplastic columnar-lined epithelium levels and on 62 (46%) columnar-lined epithelium with intestinal metaplasia levels, tissue heterogeneity was observed in clinical histopathology, with portions of squamous epithelium within the samples.Matches with pure tissue samples in both clinical and research histopathology levels were observed on 22 (26.2%) levels of metaplastic columnar-lined epithelium and in 55 (40.7%) levels of columnar-lined epithelium with intestinal metaplasia.The high proportion of mismatches and tissue heterogeneity observed, especially among columnar-lined epithelium with intestinal metaplasia and dysplasia, points to the necessity of determining the histopathology of the research samples to avoid sampling errors during molecular studies.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery.

ABSTRACT

Objectives: To determine if histopathologic assessment of esophageal biopsies harvested for research study is justified due to the heterogeneity of tissues in the esophagus, and the consequent histopathologic mis-matches with the clinical histopathology of biopsies taken at the same level.

Methods: Since 2004, patients undergoing upper endoscopy for a variety of clinical conditions were invited to provide additional esophageal biopsies; those were collected for research purpose at the same level as biopsies collected for clinical histopathology. Research biopsies were cut in two parts: one part was submitted to research histopathology and the other stored for molecular analysis. Results of clinical histopathology for each patient were summarized per biopsy level and compared to results obtained from research biopsies at the corresponding level.

Results: A total of 377 level summaries were obtained from 137 patients. Clinical histopathology summaries classified 123 levels (32.6%) as squamous epithelium, 84 levels (22.3%) as metaplastic columnar-lined epithelium, 135 levels (35.8%) as columnar-lined epithelium with intestinal metaplasia, 30 levels (8%) as dysplasia, and 5 levels (1.3%) as adenocarcinoma. Research histopathology matched to clinical summaries on 120 of 123 (97.5%) levels for squamous epithelium, 52 of 84 (61.9%) for metaplastic columnar-lined epithelium, and 94 of 135 (69.5%) for columnar-lined epithelium with intestinal metaplasia. There were no matches for dysplasia between the groups; however, they agreed on all five cases of AC. On 59 (70.2%) metaplastic columnar-lined epithelium levels and on 62 (46%) columnar-lined epithelium with intestinal metaplasia levels, tissue heterogeneity was observed in clinical histopathology, with portions of squamous epithelium within the samples. Matches with pure tissue samples in both clinical and research histopathology levels were observed on 22 (26.2%) levels of metaplastic columnar-lined epithelium and in 55 (40.7%) levels of columnar-lined epithelium with intestinal metaplasia.

Conclusions: The high proportion of mismatches and tissue heterogeneity observed, especially among columnar-lined epithelium with intestinal metaplasia and dysplasia, points to the necessity of determining the histopathology of the research samples to avoid sampling errors during molecular studies.

No MeSH data available.


Related in: MedlinePlus