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How good is zoom endoscopy for assessment of villous atrophy in coeliac disease?
Endoscopy. 2005 Oct; 37(10):994-8.E

Abstract

BACKGROUND AND STUDY AIMS

The advent of magnification endoscopy may allow the macroscopic detection of unrecognised villous atrophy in patients with unsuspected coeliac disease. In addition, it may also be possible to use this method to assess the degree of villous atrophy. The aim of this study was to determine the accuracy of zoom endoscopy for the macroscopic evaluation of villous atrophy, in comparison with histological evaluation.

PATIENTS AND METHODS

The zoom endoscope provided a magnification capability of x 115. A scoring system (Z score) was devised for grading the appearances of villous atrophy: "Z1" for normal mucosa, "Z2" for stunted villi, "Z3" for markedly stunted villi (with ridges and pits) and "Z4" for a flat mucosa. A total of 53 consecutive patients with treated coeliac disease were followed up over almost 2 years using the Olympus GIF-Q240Z zoom endoscope; a total of 80 procedures were carried out. Four biopsies from the second part of the duodenum were taken from each patient for histological assessment. Histological assessment of villous atrophy was made by a pathologist blinded to the Z score. The correlation between the Z score and the histological score was assessed using the weighted kappa method.

RESULTS

The kappa score for the correlation between the macroscopic assessment of villous atrophy and the histology was 0.631, indicating fair to good reproducibility. Agresti's method revealed a very strong baseline association between the two methods (P < 0.001). Zoom endoscopy had a positive predictive value of 83 % and a negative predictive value of 77 % in detecting villous atrophy.

CONCLUSIONS

Our findings suggest that zoom endoscopy may be valuable in assessing the degree of villous atrophy. However, further studies are needed to assess its efficacy in routine practice as a screening or case-finding tool.

Authors+Show Affiliations

University Hospital of North Durham, Durham, United Kingdom.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16189773

Citation

Badreldin, R, et al. "How Good Is Zoom Endoscopy for Assessment of Villous Atrophy in Coeliac Disease?" Endoscopy, vol. 37, no. 10, 2005, pp. 994-8.
Badreldin R, Barrett P, Wooff DA, et al. How good is zoom endoscopy for assessment of villous atrophy in coeliac disease? Endoscopy. 2005;37(10):994-8.
Badreldin, R., Barrett, P., Wooff, D. A., Mansfield, J., & Yiannakou, Y. (2005). How good is zoom endoscopy for assessment of villous atrophy in coeliac disease? Endoscopy, 37(10), 994-8.
Badreldin R, et al. How Good Is Zoom Endoscopy for Assessment of Villous Atrophy in Coeliac Disease. Endoscopy. 2005;37(10):994-8. PubMed PMID: 16189773.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - How good is zoom endoscopy for assessment of villous atrophy in coeliac disease? AU - Badreldin,R, AU - Barrett,P, AU - Wooff,D A, AU - Mansfield,J, AU - Yiannakou,Y, PY - 2005/9/29/pubmed PY - 2006/1/6/medline PY - 2005/9/29/entrez SP - 994 EP - 8 JF - Endoscopy JO - Endoscopy VL - 37 IS - 10 N2 - BACKGROUND AND STUDY AIMS: The advent of magnification endoscopy may allow the macroscopic detection of unrecognised villous atrophy in patients with unsuspected coeliac disease. In addition, it may also be possible to use this method to assess the degree of villous atrophy. The aim of this study was to determine the accuracy of zoom endoscopy for the macroscopic evaluation of villous atrophy, in comparison with histological evaluation. PATIENTS AND METHODS: The zoom endoscope provided a magnification capability of x 115. A scoring system (Z score) was devised for grading the appearances of villous atrophy: "Z1" for normal mucosa, "Z2" for stunted villi, "Z3" for markedly stunted villi (with ridges and pits) and "Z4" for a flat mucosa. A total of 53 consecutive patients with treated coeliac disease were followed up over almost 2 years using the Olympus GIF-Q240Z zoom endoscope; a total of 80 procedures were carried out. Four biopsies from the second part of the duodenum were taken from each patient for histological assessment. Histological assessment of villous atrophy was made by a pathologist blinded to the Z score. The correlation between the Z score and the histological score was assessed using the weighted kappa method. RESULTS: The kappa score for the correlation between the macroscopic assessment of villous atrophy and the histology was 0.631, indicating fair to good reproducibility. Agresti's method revealed a very strong baseline association between the two methods (P < 0.001). Zoom endoscopy had a positive predictive value of 83 % and a negative predictive value of 77 % in detecting villous atrophy. CONCLUSIONS: Our findings suggest that zoom endoscopy may be valuable in assessing the degree of villous atrophy. However, further studies are needed to assess its efficacy in routine practice as a screening or case-finding tool. SN - 0013-726X UR - https://www.unboundmedicine.com/medline/citation/16189773/How_good_is_zoom_endoscopy_for_assessment_of_villous_atrophy_in_coeliac_disease L2 - https://www.thieme-connect.com/DOI/DOI?10.1055/s-2005-870245 DB - PRIME DP - Unbound Medicine ER -