Gan Hua Tian, Chen You Qin, Ouyang Qin, Bu Hong, Yang Xiu Ying
Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, PR China.
Am J Gastroenterol. 2002 Jun;97(6):1446-51. doi: 10.1111/j.1572-0241.2002.05686.x.
It is difficult to differentiate intestinal tuberculosis from Crohn's disease because of similar clinical, pathological, radiological, and endoscopic findings. The purpose of this study was to investigate the value of polymerase chain reaction (PCR) assay in the differentiation intestinal tuberculosis from Crohn's disease, and compare the histopathological features of endoscopic biopsy of the two disorders.
A total of 39 endoscopic biopsy specimens from patients with intestinal tuberculosis and 30 specimens from patients with Crohn's disease were subjected to pathological analysis retrospectively, Ziehl-Neelsen stain, and PCR assay.
Except for granuloma with caseation and confluence, which was the characteristic of intestinal tuberculosis, other pathological features of intestinal tuberculosis and Crohn's disease were very similar or were difficult to find in endoscopic biopsy specimens. The positivity rate by PCR in 39 intestinal tuberculosis specimens was 64.1% (25/39), but was zero by PCR in 30 Crohn's disease specimens. Moreover, in the tissues of intestinal tuberculosis with granulomas similar to those of Crohn's disease, there were 71.4% (10/14) positive by PCR, and there were 61.1% (11/18) positive in intestinal tuberculosis tissues without granulomas.
Biopsy is of limited diagnostic value in the differentiation intestinal tuberculosis from Crohn's disease, and PCR is valuable in the differentiation between intestinal tuberculosis and Crohn's disease.
由于肠道结核和克罗恩病在临床、病理、放射学及内镜检查结果上相似，难以将两者区分开来。本研究旨在探讨聚合酶链反应（PCR）检测在鉴别肠道结核和克罗恩病中的价值，并比较这两种疾病内镜活检的组织病理学特征。
对39例肠道结核患者的内镜活检标本和30例克罗恩病患者的标本进行回顾性病理分析、萋尼氏染色及PCR检测。
除了干酪样坏死及融合性肉芽肿为肠道结核的特征外，肠道结核和克罗恩病的其他病理特征非常相似，或在内镜活检标本中难以发现。39例肠道结核标本的PCR阳性率为64.1%（25/39），而30例克罗恩病标本的PCR阳性率为零。此外，在肉芽肿与克罗恩病相似的肠道结核组织中，PCR阳性率为71.4%（10/14），在无肉芽肿的肠道结核组织中阳性率为61.1%（11/18）。
活检在鉴别肠道结核和克罗恩病方面诊断价值有限，而PCR在鉴别肠道结核和克罗恩病中具有重要价值。
