P080 Histopathologic evaluation and lymphocyte subpopulations of the duodenal mucosa of Crohn’s disease
Bibliographic record
Abstract
The histopathology of the duodenum of adult Crohn's disease (CD) patients is practically unexplored. Lymphocytic enteritis and duodenal atrophy are considered lesions of the CD histological spectrum but its prevalence is not known (<5% in the general population). In some cases it raises the differential diagnosis with celiac disease. It is unknown whether the so-called celiac cytometric pattern (Fernández-Bañares, PLoS One 2012) is useful in this context. The aims of this study were to assess (1) histopathological abnormalities of the duodenum in CD and their related factors. (2) Intestinal lymphocyte subpopulations related to celiac disease cytometric pattern in the duodenum of CD patients. Retrospective and observational study. Patients were identified from the ENEIDA local database (431 CD), of whom a duodenal biopsy were available (inclusion period: 2002–2017). Clinical characteristics (early CD vs. long-lasting CD, indication for upper gastrointestinal assessment, activity: calprotectin levels and Harvey-Bradshaw scores, Montreal Classification, treatment, celiac disease work-up and stool parasites), endoscopic and histopathological features (intraepithelial lymphocytosis, duodenal mucosal atrophy, inflammatory infiltrate, granulomas, and the presence of H. pylori) were recorded. The celiac cytometric pattern (TCRγ-delta cells >8% and CD3- lymphocytes <10%) was evaluated in a subset of patients. The chi-square test was used to compare groups. We included 72 patients with gastroscopy and duodenal biopsies (47 women, mean age: 47 ± 16.4 years). Of these, 32 (44.4%) showed endoscopic abnormalities (15 aphtha and 17 gastroduodenitis). Duodenal histology showed alterations in 47 (65.3%): lymphocytic enteritis (n = 44, 61.1%), non-celiac duodenal atrophy (n = 2, 2.8%), chronic inflammatory infiltrate (n = 12, 16.7%) and granulomas (n = 3, 4.2%). In 11 patients, lymphocytic enteritis could be attributed to a cause other than CD (4 H. pylori, two celiac disease, two NSAIDs, three parasites). The study of lymphocyte subpopulations (n = 17) showed: complete celiac pattern (2.8%); CD3− < 10% (4.2%); non-celiac pattern (93%). CD3− was >20% in 41.2% of CD patients. No relationship was found between histopathological abnormalities, activity, treatment and early vs. long-lasting Crohn's disease. Lymphocytic enteritis (and not duodenal atrophy) is a very common histopathological lesion of the duodenum of CD patients even in macroscopically normal mucosa. In half of the cases there is >20% of CD3− subpopulations, which can be cytotoxic cells.
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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 | 0.000 | 0.001 |
| 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 | 0.001 |
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".