{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T09:18:30Z","timestamp":1787649510953,"version":"build-2736575974"},"reference-count":31,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2025,9,24]],"date-time":"2025-09-24T00:00:00Z","timestamp":1758672000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Int J Surg Pathol"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:p>\n                    The intraepithelial lymphocyte (IEL) thresholds in diagnosing celiac disease (CD) have limited diagnostic value and low specificity. This study investigated the predictive value of localization-based examination and counting of IEL in diagnosing CD. Duodenal biopsies (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    \u2009=\u2009418) from pediatric and adult age groups who applied in 2021\u20132023 were re-examined. The mean number of total and supranuclear lymphocytes per 100 (IEL\/100, SupIEL\/100) and 20 (IEL\/20, SupIEL\/20) enterocytes in the villus tip were counted with CD3-stained slides. The SupIEL ratio was obtained by SupIEL\/Total IEL. ROC analysis was used to determine thresholds that predicted the diagnosis of CD. The distribution pattern was defined as basal, mixed, and apical, based on the part where the IELs were found in a proportion of \u22650.60 according to the enterocyte nucleus. The most common pattern in the CD group (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    \u2009=\u2009195) was mixed (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    \u2009=\u2009127, 65.1%), while the basal pattern (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    \u2009=\u2009213, 95.5%) constituted the majority of non-CD samples (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    \u2009=\u2009223), despite some of which had increased IEL (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    \u2009=\u200969, 31.0%). All (100.0%) biopsies exhibiting an apical pattern were consistently in the CD group, while 98.6% of those exhibiting a basal pattern were in the non-CD. The positive and negative predictive values of SupIEL\/100\u2009&gt;\u200916, SupIEL\/100 ratio\u2009&gt;\u20090.40, SupIEL\/20\u2009&gt;\u20093, and SupIEL\/20 ratio\u2009&gt;\u20090.33 were 95.8\/95.1, 94.4\/95.1, 97.0\/98.2, and 75.2\/95.8, respectively. In the multivariable logistic regression analyses, the SupIEL\/100 ratio\u2009&gt;\u20090.40 was found to be an independent parameter predicting CD. This study first revealed that examining duodenal tissues focused on IEL localization provided a more reliable and accurate prediction of CD than all previously proposed ones.\n                  <\/jats:p>","DOI":"10.1177\/10668969251378674","type":"journal-article","created":{"date-parts":[[2025,9,24]],"date-time":"2025-09-24T14:39:31Z","timestamp":1758724771000},"page":"350-360","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Supranuclear Distribution of Intraepithelial Lymphocytes is a More Reliable Parameter for the Diagnosis of Celiac Disease"],"prefix":"10.1177","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8216-1753","authenticated-orcid":false,"given":"Fatih","family":"Yilmaz","sequence":"first","affiliation":[{"name":"Mardin Training and Research Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1839-3995","authenticated-orcid":false,"given":"Guldidar","family":"Basmaci","sequence":"additional","affiliation":[{"name":"Mardin Training and Research Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9884-1112","authenticated-orcid":false,"given":"Bahattin","family":"Erdogan","sequence":"additional","affiliation":[{"name":"Eskisehir City Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7570-3638","authenticated-orcid":false,"given":"Kadri","family":"Atay","sequence":"additional","affiliation":[{"name":"Mardin Training and Research Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3829-4978","authenticated-orcid":false,"given":"Gul","family":"Cirkin","sequence":"additional","affiliation":[{"name":"Mardin Training and Research Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,9,24]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41572-018-0054-z"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/0016-5085(92)91819-P"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/MPG.0000000000003540"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2018.12.010"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpg.2005.02.006"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00281-012-0316-x"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/0950-3528(95)90032-2"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1111\/his.14262"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.14309\/ajg.0000000000002075"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2017-314297"},{"issue":"2","key":"e_1_3_3_12_2","first-page":"73","article-title":"Coeliac disease: to classify or not to classify - that is the question!","volume":"9","author":"Ensari A","year":"2016","unstructured":"Ensari A. Coeliac disease: to classify or not to classify - that is the question!. Gastroenterol Hepatol Bed Bench. 2016;9(2):73\u201374.","journal-title":"Gastroenterol Hepatol Bed Bench"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1136\/jcp.2004.023978"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2021-326257"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-2002-34255"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.anndiagpath.2025.152438"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1097\/00042737-199910000-00019"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF01606454"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.5858\/134.6.826"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1309\/5PRJ-CM0U-6KLD-6KCM"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1136\/gut.12.12.988"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1136\/jcp.55.5.393"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2559.2004.01775.x"},{"key":"e_1_3_3_24_2","volume-title":"Mills and Sternberg's Diagnostic Surgical Pathology","author":"Longacre TA","year":"2022","unstructured":"Longacre TA. 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