Assessment of the histological quality of endoscopic biopsies obtained from the canine gastro-esophageal junction

Summary

Objective: In the dog biopsy samples from the gastro-esophageal junction (GEJ) are rarely obtained during routine gastroscopy. The aim of this pilot study was to assess the histological quality of endoscopic biopsies sampled from the canine esophagus and cardia. It was hypothesised that it is possible to sample adequate specimens from these sites.

Materials and methods: For this purpose 10 dogs with an indication for gastroscopy were enrolled in a prospective study. Biopsy samples were obtained with standard biopsy forceps for single use exactly from the GEJ thus containing preferably columnar epithelium from the cardia and squamous epithelium from the esophagus, respectively. In every dog the specimens were examined for size, layers and site, respectively. Study endpoint was reached when specimens originated from cardia and esophagus, showing at least epithelium and lamina propria mucosae, and a diameter > 2 mm on the slide, respectively.

Results: 72 biopsy specimens (median 7, range 5–10) obtained from the GEJ were examined in 10 dogs. Specimens from the esophagus containing squamous epithelium with lamina propria mucosae were found in 5 of 10 (50.0%) dogs. Specimens from the cardia containing columnar epithelium with lamina propria mucosae were found in 10 of 10 (100.0%) dogs. Four of 10 (40.0%), and 10 of 10 (100.0%) dogs showed at least one specimen > 2 mm on the slide originating from the esophagus, and from the cardia, respectively. Histological quality was found to be adequate in 4 of 10 (40.0%) dogs, showing specimens of adequate size, originating from both esophagus and cardia, and containing at least epithelium and lamina propria mucosae.

Conclusion and clinical relevance: The pilot study provides evidence that during routine gastroscopy it is possible to sample endoscopic biopsies from the cardia and with limitations from the esophagus showing a quality adequate for histological examination of the epithelium and the lamina propria mucosae.

Zusammenfassung

Gegenstand und Ziel: Beim Hund werden während Routine-Gastroskopien nur selten Bioptate aus dem gastroösophagealen Übergang entnommen. Die Zielsetzung dieser Pilotstudie war die Bestimmung der histologischen Qualität von Bioptaten aus Ösophagus und Kardia. Die Arbeitshypothese lautete, dass beim Hund die Gewinnung histologisch auswertbarer Bioptate aus diesen Lokalisationen möglich ist.

Material und Methode: Zu diesem Zweck wurden 10 Hunde mit Indikation zur Gastroskopie prospektiv untersucht. Während Routine-Gastroskopien erfolgten Biopsien mittels zum Einmalgebrauch bestimmter Standard-Biopsiezangen exakt aus dem gastroösophagealen Übergang. Proben aus der Kardia enthielten Zylinderepithel und Proben aus dem Ösophagus Plattenepithel. Bei jedem Hund wurden die Proben auf ihre Größe, ihre Schichten und ihre Herkunft untersucht. Der Studienendpunkt war erreicht, wenn die Proben Mukosa von Kardia und Ösophagus zeigten, mindestens Epithel und Lamina propria mucosae enthielten und eine Größe von > 2 mm auf dem Objektträger aufwiesen.

Ergebnisse: Bei 10 Hunden wurden 72 Bioptate (Median 7, Bereich 5–10) aus dem gastroösophagealen Übergang ausgewertet. Die Proben des Ösophagus enthielten Plattenepithel mit Lamina propria mucosae bei 5 von 10 (50,0%) Hunden und Zylinderepithel mit Lamina propria mucosae der Kardia bei 10 von 10 (100,0%) Hunden. Eine Probengröße von > 2 mm auf dem Objektträger fand sich bei 4 von 10 (40,0%) Hunden in Ösophagusbioptaten und bei 10 von 10 (100,0%) Hunden in Kardiabioptaten. Die histologische Qualität wurde bei 4 von 10 (40,0%) Hunden als adäquat angesehen, da diese Proben Gewebe aus dem Ösophagus wie auch aus der Kardia aufwiesen, ausreichend groß waren und mindestens Epithel und Lamina propria mucosae enthielten.

Schlussfolgerung und klinische Relevanz: Die Pilotstudie liefert Belege dafür, dass bei Routine-Gastroskopien aus der Kardia meistens und aus dem Ösophagus mit Einschrän- kungen Probenmaterial gewonnen werden kann, das sich zur histologischen Untersuchung von Epithel und Lamina propria mucosae eignet.

Key words

Esophagoscopy - histology - esophagus - stomach - z-line - biopsy- technique

Schlüsselwörter

Ösophagoskopie - Histologie - Speiseröhre - Magen - Z-Linie - Biopsietechnik

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