UPPER GASTROINTESTINAL BIOPSIES AND PEDIATRIC CROHN'S DISEASE
Bibliographic record
Abstract
Introduction: The role of gastric biopsies in the diagnosis of pediatric Crohn's disease (CD) have not been well established. To date, histological changes associated with upper gastrointestinal(GI) CD include granuloma and focal (enhanced) active gastritis. Aim: To determine the role of upper GI biopsies and particularly gastric biopsies in the diagnosis of pediatric CD. Methods: A cohort of randomly selected IBD patients was chosen from the British Columbia Children's (BCCH) IBD database (age 5-17 years) diagnosed with CD, ulcerative colitis (UC) and indeterminate colitis between 1998-2005. Only patients with both upper and lower GI tract biopsies taken at diagnosis were included. Two blinded pathologists reviewed all at diagnosis H&E stained slides. Standard histological criteria were used to diagnose CD and UC. H&E stained slides of esophageal, duodenal, gastric antral and body biopsies were coded and examined for focal/diffuse, superficial/deep, acute/chronic inflammation, focal enhanced gastritis, cryptitis and granuloma. Results: Sixty-two patients (31 males, age range 5-17 years, mean age 12.5 years) were identified; 46 CD, 9 UC, 4 IC and 3 with non-specific inflammation. CD patients demonstrated inflammation in the antrum (34/46, 74%), body (33/46,71%), esophagus (28/46, 60%) and duodenum (24/46, 52%). In antral biopsies, chronic superficial/deep inflammation was evident in 34/34 positive biopsies, chronic diffuse inflammation in 25/34 (74%) and chronic multifocal inflammation in 17/34 (50%). Focal active gastritis was observed in 23/34 CD patients (68%). Granuloma was observed in 14/34 CD patients (41%) involving the gastric body, 5/14 (35%), antrum, 4/14 (28%), esophagus, 4/14 (28%) and duodenum, 2/14 (14%). Non-specific gastritis was observed in 66% of UC patients. Conclusions: Gastric biopsies and particularly antral biopsies appear useful in the identification of children with CD. Further studies are required to examine the usefulness of gastric biopsies in the diagnosis of Crohn's disease.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".