Usefulness of the Eosinophilic Esophagitis Histologic Scoring System in Distinguishing Active Eosinophilic Esophagitis From Remission and Gastroesophageal Reflux Disease
Bibliographic record
Abstract
BACKGROUND: Eosinophilic esophagitis (EoE) is defined as esophageal dysfunction in the presence of > 15 intraepithelial eosinophils per high-power field (eos/hpf) in either the mid or distal esophagus. The current focus of EoE pathologic evaluation is the peak eosinophil count (PEC), although histologic features other than eosinophilic inflammation are also commonly observed. In addition, histologic variance between the mid and distal esophagus in EoE has not been rigorously studied. The aim of our study was to utilize a recently developed EoE histologic scoring system (EoEHSS) to compare the mid and the distal esophageal histology in patients with active EoE (EoE-A), EoE in remission (EoE-R), and gastroesophageal reflux disease (GERD). METHODS: EoEHSS was used to prospectively evaluate the severity and extent of changes in multiple histopathologic features (PEC; basal zone hyperplasia (BZH); eosinophilic abscesses (EA); eosinophil surface layering (ESL); dilated intercellular spaces (DIS); surface epithelial alteration (SEA); dyskeratotic epithelial cells (DEC); lamina propria fibrosis (LPF)) in the mid and distal esophageal biopsies in 85 pediatric patients at a tertiary medical center. These patients were divided into three cohorts: EoE-A (n = 36), EoE-R (n = 12) and GERD (n = 37). RESULTS: Total grade (severity) and stage (extent) scores were significantly higher in EoE-A compared to EoE-R and GERD patients in both the mid and the distal esophagus. The mean total grade scores in the mid esophagus, but not the distal esophagus remained higher in EoE-R as compared to GERD patients. Specific histopathologic features independent of PEC were different in distal and mid esophagus in EoE-A. About one-half of children with active EoE had different EoEHSS scores in their mid and distal esophageal biopsies. CONCLUSIONS: EoEHSS yields histologic insights beyond those derived from PEC and helps in more objective, reproducible and accurate diagnosis of EoE and GERD. It also provides a more comprehensive understanding into the pathophysiology of EoE.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
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 | 0.002 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 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".