Reinholt F P, Veress B, Lindquist K, Liljeqvist L
Department of Pathology, Huddinge University Hospital, Sweden.
APMIS. 1989 Feb;97(2):97-104. doi: 10.1111/j.1699-0463.1989.tb00762.x.
Little is known about the long-term effects on the reservoir mucosa in patients with ulcerative colitis and familial polyposis coli who undergo proctocolectomy with subsequent construction of ileal reservoir/pouch and ileoanal anastomosis. In these patients, questions regarding adaptation towards a more colon-like mucosa and/or development of (pre)malignant changes are of particular importance. With the aim of designing a method for reliable evaluation of the mucosa in the ileal pouch, biopsies from 10 patients were studied by semiquantitative assessment and morphometry. The findings were compared with those obtained from normal jejunum, ileum, and colon. The following parameters were found to be important: Villous surface density, quantity of goblet cells, number of mitoses, and the presence/absence of predominantly sulphated mucin+ goblet cells. The number of Paneth cells did not show significant changes. The villous surface density was determined by a cycloid test system applied to vertical sections. Semiquantitative assessment was a sufficiently precise method for the evaluation of the quantity of goblet cells. The counting of sulphated mucin+ goblet cells was not reproducible, instead a simple statement about the presence or absence of these cells was judged to be adequate. The number of mitoses and of Paneth cells were counted directly. During the first year of function the ileal pouch showed signs of adaptation towards a colon-like mucosa: Reduction of villous surface density, increased mitotic activity, and appearance of sulphated mucin+ goblet cells. The number of Paneth cells did not show significant changes. The amount of goblet cells was generally not increased, rather reduced in some patients.
对于溃疡性结肠炎和家族性结肠息肉病患者，在接受直肠结肠切除术后进行回肠储袋/囊袋构建及回肠肛管吻合术，目前对其储袋黏膜的长期影响知之甚少。在这些患者中，关于向更类似结肠黏膜的适应性变化和/或（癌前）恶性病变发展的问题尤为重要。为了设计一种可靠评估回肠袋黏膜的方法，对10例患者的活检组织进行了半定量评估和形态测量研究。将研究结果与正常空肠、回肠和结肠的结果进行比较。发现以下参数很重要：绒毛表面密度、杯状细胞数量、有丝分裂数以及主要含硫酸化黏蛋白的杯状细胞的有无。潘氏细胞数量未显示出显著变化。绒毛表面密度通过应用于垂直切片的摆线测试系统测定。半定量评估是评估杯状细胞数量的一种足够精确的方法。含硫酸化黏蛋白的杯状细胞计数不可重复，相反，关于这些细胞的有无的简单描述被认为是足够的。有丝分裂数和潘氏细胞数直接计数。在功能的第一年，回肠袋显示出向类似结肠黏膜适应的迹象：绒毛表面密度降低、有丝分裂活性增加以及含硫酸化黏蛋白的杯状细胞出现。潘氏细胞数量未显示出显著变化。杯状细胞数量一般没有增加，在一些患者中反而减少。
