Evaluation of the quality of endoscopically obtained esophageal biopsies in the dog

 

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Summary

Objective: An important premise for obtaining diagnostically relevant histology specimens is an appropriate biopsy technique. Goal of this study was to determine if biopsies of adequate quality can be obtained from the canine esophagus at the gastro-esophageal junction (GEJ) during routine upper gastrointestinal endoscopy. Material and methods: Over the course of one year, 58 dogs undergoing upper gastrointestinal endoscopy because of the presence of esophageal (n = 22) or gastrointestinal (n = 36) clinical signs were prospectively included. Five biopsies were repeatedly collected from the same dorsal and ventral locations of the GEJ, fixated individually in 4% neutral buffered formaldehyde, and evaluated histopathologically after standard preparation and haematoxylin and eosin staining. The presence of esophageal squamous epithelium with a basal cell layer and lamina propria mucosae in conjunction with foveolar columnar epithelium and cardiac glands, and the absence of fundic glands in one specimen, respectively, was judged as an adequately sampled biopsy. Results: Adequately sampled biopsies were reported in 45 out of 58 dogs, with 31 samples originating from the dorsal GEJ, 36 samples originating from the ventral GEJ, and with 22 samples originating from both sites, respectively. The incidence of adequately sampled biopsies increased significantly over time (r = 0,22; p < 0,05), with these biopsies being reported significantly more often during the last 6 months compared to the first 6 months of the study (p = 0,03). Histopathological evaluation of the esophageal squamous epithelium showed fibrosis, inflammation, elongation of the stromal papillae, and increased thickness of the basal cell layers in 14 out of 58 dogs. Stromal papillae of the ventral esophageal epithelium were significantly elongated in dogs with esophageal clinical signs compared to dogs with gastrointestinal clinical signs (p = 0,03). Conclusion and clinical relevance: After an initial learning phase adequate esophageal biopsies from the GEJ can be obtained in canine patients undergoing upper gastrointestinal endoscopy, and histological lesions can be found in these biopsies.

Zusammenfassung

Gegenstand und Ziel: Eine geeignete Biopsietechnik ist eine wesentliche Voraussetzung zur Gewinnung von histologisch adäquatem und diagnostisch relevantem Probenmaterial. Ziel dieser Studie war zu ermitteln, ob beim Hund bei Routinegastroskopien Bioptate geeigneter Qualität aus dem Ösophagus und vom gastroösophagealen Übergang gewonnen werden können. Material und Methoden: Im Lauf eines Jahres wurden 58 Hunde, bei denen wegen ösophagealer (n = 22) und gastrointestinaler (n = 36) Symptome eine Indikation zur Gastroskopie bestand, prospektiv untersucht. Aus dem gastroösophagealen Übergang wurden dorsal und ventral jeweils fünf Bioptate entnommen, in zwei getrennte Probenbehälter gegeben, in 4%igem neutral gepuffertem Formalin fixiert und nach Standardpräparation und Hämatoxilin-Eosin-Färbung histopathologisch ausgewertet. Qualitätsmerkmal für eine adäquat entnommene Probe war das Vorliegen von Plattenepithel des Ösophagus mit Basalzellschicht und Lamina propria mucosae und von foveolärem Zylinderepithel mit Kardiadrüsen bei Fehlen von Fundusdrüsen. Ergebnisse: In geeigneter Weise am gastroösophagealen Übergang entnommene Bioptate fanden sich bei 45 von 58 Hunden, wobei 31 Proben aus dem dorsalen gastroösophagealen Übergang, 36 aus dem ventralen gastroösophagealen Übergang und 22 aus beiden Lokalisationen zugleich stammten. Die Anzahl adäquat gewonnener Bioptate nahm mit der Studiendauer signifikant zu (r = 0,22; p < 0,05). In den zweiten 6 Monaten der Studie lag ihre Zahl signifikant höher als in den ersten 6 Monaten (p = 0,03). Die histopathologische Untersuchung des ösophagealen Plattenepithels ergab bei 14 von 58 Hunden Fibrose, Entzündung, Verlängerung der Stromapapillen und Verbreiterung der Basalzellschicht. Die Stromapapillen des ventralen ösophagealen Plattenepithels waren bei Hunden mit ösophagealen Symptomen signifikant länger als bei Hunden mit gastrointestinalen Symptomen (p = 0,03). Schlussfolgerungen und klinische Relevanz: Nach einer Lernphase können bei Hunden während der Gastroskopie adäquate Bioptate aus dem Bereich des gastroösophagealen Übergangs gewonnen werden, in denen sich histopathologisch strukturelle Läsionen nachweisen lassen.

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