To validate cut-off values of CD3+ T-cell receptor gamma-delta chain (TCRγδ+) intraepithelial lymphocyte (IEL) in the (differential) diagnosis of celiac disease (CD).
CD is characterized by an increase in gamma-delta IEL (CD3+TCRγδ+ IEL).
Percentages were determined by flow cytometric analysis of IELs from small bowel biopsies in 213 CD and 13 potential CD (PCD) patients and in total 112 controls. A cut-off value for percentages of CD3+TCRγδ+ IEL to differentiate active CD and controls was obtained from a receiver operating characteristic curve and implemented in controls and PCD patients.
Percentage of CD3+TCRγδ+ IEL was significantly increased in the majority of CD patients, irrespective of the presence of villous atrophy. A cut-off value of 14% for CD3+TCRγδ+ IEL resulted in 66.3% sensitivity and 96.6% specificity for CD diagnosis (area under the curve, 88.6%).
A percentage of ≥14% CD3+TCRγδ+ IEL has a high specificity for CD diagnosis and can be of diagnostic help in cases where diagnosis is not straightforward.
Departments of *Gastroenterology and Hepatology, Coeliac Center Amsterdam
†Clinical Chemistry, Medical Immunology
‡Epidemiology and Biostatistics, VU University Medical Center Amsterdam, Amsterdam, The Netherlands
Present address: Gerd Bouma, MD, PhD, Department of Gastroenterology and Hepatology, VU University Medical Centre, P.O. Box 7057, Amsterdam 1007 MB, The Netherlands.
The authors declare that they have nothing to disclose.
Address correspondence to: Gerd Bouma, MD, PhD, Department of Gastroenterology and Hepatology, Coeliac Center Amsterdam (e-mail: email@example.com).
Received November 30, 2017
Accepted April 12, 2018