组织病理学在克罗恩病活动度评估中的作用是什么？

What is the role of histopathology in the evaluation of disease activity in Crohn's disease?

机构信息

Department of Pathology and Laboratory Medicine, Mayo Clinic Arizona, Scottsdale, AZ, USA.

Department of Epidemiology and Biostatistics, University of Western Ontario, London, Ontario, Canada; Department of Medicine, University of Western Ontario, London, Ontario, Canada.

出版信息

Best Pract Res Clin Gastroenterol. 2019 Feb-Apr;38-39:101601. doi: 10.1016/j.bpg.2019.02.003. Epub 2019 Feb 15.

DOI:10.1016/j.bpg.2019.02.003

PMID:31327406

Abstract

Assessment of disease activity is essential for developing and determining appropriate therapy in patients with Crohn's disease. Currently, clinical and endoscopic treatment targets have been proposed, whereas histologic assessment of disease activity is not recommended in expert guidelines. Histologic assessment of disease activity has emerged as an important tool in ulcerative colitis as persistent histological inflammation is associated with clinical relapse, corticosteroid use, hospitalisation, and development of dysplasia. Similar data for Crohn's disease is limited but emerging literature suggests that histologic evaluation of disease activity may have value. This review summarizes the recent literature regarding histologic evaluation of disease activity in Crohn's disease. Correlation between histologic, endoscopic, and other markers of disease activity are discussed. Histologic scoring systems in Crohn's disease are described and practical guidance is provided to gastroenterologists and pathologists on how to report and interpret histologic data.

摘要

评估疾病活动对于克罗恩病患者制定和确定适当的治疗方案至关重要。目前，已经提出了临床和内镜治疗目标，但专家指南不建议对疾病活动进行组织学评估。组织学评估疾病活动已成为溃疡性结肠炎的重要工具，因为持续的组织学炎症与临床复发、皮质类固醇的使用、住院和发育不良有关。类似的克罗恩病的数据有限，但新出现的文献表明，疾病活动的组织学评估可能具有价值。这篇综述总结了最近关于克罗恩病疾病活动的组织学评估的文献。讨论了组织学、内镜和其他疾病活动标志物之间的相关性。描述了克罗恩病的组织学评分系统，并为胃肠病学家和病理学家提供了关于如何报告和解释组织学数据的实用指南。