Table 1.
Cohort inclusion and exclusion criteria.
Table 2.
Demographics of the study cohorts.
Table 3.
Histologic category and scoring scheme.
Table 4.
Concordance measures of EED duodenal histology index.
Fig 1.
Total histology score percent, by cohort.
Compared to the St. Louis GSE cohort, the St. Louis control, Pakistani and Zambian cohorts had lower total histology scores (p<0.0001, p = 0.0005, and p = 0.02, respectively). Total histology score percent did not differ significantly between the Pakistani and Zambian WSIs (p = 0.13). Statistical analysis was performed by Kruskal-Wallis test followed by Dunn’s multiple comparisons test with Benjamini-Hochberg correction for false discovery error rate. *: p ≤ 0.05; **: p ≤ 0.01; ****: p ≤ 0.0001. The bars indicate mean ± standard deviation.
Table 5.
Median total histology score and total histology score percent by cohort.
Fig 2.
Scores of individual histology features, by cohort.
The GSE cohort had the highest scores in the categories of (A) chronic inflammation and (B) intramucosal Brunner’s gland. Between the Pakistani and Zambian cohorts, the Pakistani cohort had (C) more intraepithelial lymphocytes. In contrast, the Zambian cohort had higher scores in the categories of (D) goblet cell density, (E) Paneth cell density, (F) enterocyte injury, and (G) epithelial detachment. The Zambian cohort also tended to have higher scores in (H) villous architecture derangement. Sample size: Pakistani n = 10, Zambian n = 16, GSE n = 13, control n = 6. *: p ≤ 0.05; **: p ≤ 0.01; ***: p ≤ 0.001; ****: p ≤ 0.0001. Statistical analysis was performed by Kruskal-Wallis test followed by Dunn’s multiple comparisons test and corrected within tests for false discovery rate by the Benjamini-Hochberg method. The bars indicate mean ± standard deviation.
Fig 3.
Individual histology heterogeneity, Pakistani cohort.
The scores for each individual biopsy for each subject were plotted for (A) total EED histology score percent, (B) villous architecture, and (C) intramucosal Brunner glands as these showed the highest variability between biopsies. The bars indicate mean ± standard deviation.
Table 6.
Overall concordance of histologic parameters based on number of tissue fragments assessed per image.