*Department of Pathology, University Hospital of Nancy, Vandoeuvre-lès-Nancy, France; and †Inserm U954 and Department of Hepato-Gastroenterology, University Hospital of Nancy, Université de Lorraine, Vandoeuvre-lès-Nancy, France.
Inflamm Bowel Dis. 2015 Feb;21(2):468-75. doi: 10.1097/MIB.0000000000000224.
Recurrence of Crohn's disease (CD) after ileal or colonic resection is common. Many studies have tried to identify predictors of postoperative recurrence (POR) in CD. A wide range of histologic features have been identified, but for most of them, the literature provided conflicting data. In last years, several studies have suggested that histologic findings including inflammatory changes within the enteric nervous system of the resection margin may be associated with CD recurrence. Herein, after briefly summarizing pathophysiology of POR, we review all histological features that have been studied so far: granulomas, histologic appearance at the margin of resection, plexitis, lymphatic vessel density in proximal margin of resection, and morphological analysis of Paneth cells. Granulomas and chronic inflammation at the margin of resection do not seem to predict POR in CD. Active disease at the margin of resection, plexitis, lymphatic vessels density, morphological analysis of Paneth cells may predict POR. Most of these histological features await replication in independent studies. Available evidence indicates that histological findings may be taken into account when developing strategies aimed at preventing postoperative CD recurrence.
回肠或结肠切除术后克罗恩病（CD）的复发很常见。许多研究试图确定 CD 术后复发（POR）的预测因素。已经确定了广泛的组织学特征，但对于大多数特征，文献提供的数据相互矛盾。近年来，多项研究表明，包括切除边缘肠神经系统内炎症变化在内的组织学发现可能与 CD 复发相关。在此，简要总结 POR 的发病机制后，我们回顾了迄今为止研究过的所有组织学特征：肉芽肿、切除边缘的组织学表现、神经丛炎、切除近端边缘的淋巴管密度，以及 Paneth 细胞的形态分析。肉芽肿和切除边缘的慢性炎症似乎不能预测 CD 的 POR。切除边缘的活动性疾病、神经丛炎、淋巴管密度、Paneth 细胞的形态分析可能预测 POR。这些组织学特征中的大多数有待于在独立研究中复制。现有证据表明，在制定旨在预防术后 CD 复发的策略时，可以考虑组织学发现。
