Accuracy of liquid cytology in the diagnosis and monitoring of eosinophilic oesophagitis

作者：Rodriguez Sanchez Joaquin^*; Garcia Rojo Marcial; Lopez Viedma Bartolome; de la Santa Belda Eva; Olivencia Palomar Pilar; Gomez Torrijos Elisa; Gonzalez Lopez Lucia; Olmedo Camacho Jose

来源：United European Gastroenterology Journal, 2014, 2(6): 475-481.

DOI：10.1177/2050640614552315

• Eosinophilic esophagitis
• cytology
• Cytosponge
• GERD
• eosinophil

Background: Oesophagoscopy with biopsy is considered the gold standard for diagnosing and monitoring eosinophilic oesophagitis (EoE). Therefore is important to discover less-invasive diagnostic methods.
Methods: Cytology specimens were obtained in patients with active EoE (AEoE) (>= 15 eos/hpf) and EoE in remission (EoER) (<15 eos/hpf). The samples were assessed by two independent pathologists and were compared with biopsy samples. EoE cytology specimens were compared with specimens obtained from patients with GERD.
Results: Specimens of 36 patients (69.4% male, mean age 30.88 years) were included. AEoE (17, 47.2%), EoER (11, 30.5%) and GERD (22.2%). eos/hpf in cytology (AEoE 9.23 vs. EoER 1.54 vs. GERD 2, p = 0.01). Linear correlation between eos/hpf average biopsy and cytology eos/hpf: r = 0.57, p < 0.001. For diagnosis of EoE >= 3 eos/hpf in cytology obtained a sensitivity of 70%, specificity 81%, PPV 86% and NPV 60% (AUC = 0.81, p = 0.01). For detection of AEoE, >= 3 eos/hpf in LBC obtained a sensitivity of 70%, specificity 82%, PPV 81% and NPV 66% (AUC = 0.87, p = 0.001).
Conclusions: LBC in oesophageal aspirate seems to be effective for the diagnosis and monitoring activity in EoE. These results support the usefulness of non-invasive methods for the diagnosis and monitoring of EoE.