Xia Rong, Zhang Xuchen
Department of Pathology, State University of New York, Downstate Medical Center, Brooklyn, NY 11203, United States.
Department of Pathology, Yale University School of Medicine, New Haven, CT 06520, United States.
World J Gastrointest Pathophysiol. 2019 Oct 15;10(3):36-41. doi: 10.4291/wjgp.v10.i3.36.
Neutropenic enterocolitis (NE) is a predominantly cecum-based disease with high mortality seen in patients post chemotherapy. The pathogenesis of NE is poorly understood and probably multifactorial involving mucosal injury, neutropenia, and impaired host defense to intestinal organisms. The clinical presentation is characterized as ileocolonic inflammation and bowel wall thickening in patients with neutropenia, fever, and abdominal pain. The pathological features of NE include patchy necrosis, hemorrhage, ulcer, edema, perforation, infiltrating organisms, and characteristically, depletion of inflammatory cells (neutrophils). NE should always be considered as a possible diagnosis in immunosuppressed patients, especially those receiving chemotherapy. High clinical and histological diagnostic discordance rate exists. High index of clinical suspicion and prompt appropriate personalized management are essential to achieve a lower mortality rate.
中性粒细胞减少性小肠结肠炎（NE）是一种主要累及盲肠的疾病，在化疗后的患者中死亡率较高。NE的发病机制尚不清楚，可能是多因素的，涉及黏膜损伤、中性粒细胞减少以及宿主对肠道微生物的防御功能受损。临床表现为中性粒细胞减少、发热和腹痛患者的回结肠炎症和肠壁增厚。NE的病理特征包括片状坏死、出血、溃疡、水肿、穿孔、微生物浸润，其特征性表现为炎症细胞（中性粒细胞）减少。对于免疫抑制患者，尤其是接受化疗的患者，应始终将NE视为一种可能的诊断。临床和组织学诊断的不一致率较高。高度的临床怀疑指数和及时适当的个性化管理对于降低死亡率至关重要。
