Gastroenterology Department, Hospital de Galdakao, Barrio Labeaga, 48960 Galdakao (Vizcaya), Spain; Biocruces Bizkaia Health Research Institute, Plaza de Cruces, 48903 Barakaldo (Vizcaya), Spain.
Gastroenterology Department, Hospital de Galdakao, Barrio Labeaga, 48960 Galdakao (Vizcaya), Spain.
Dig Liver Dis. 2020 Dec;52(12):1467-1472. doi: 10.1016/j.dld.2020.05.052. Epub 2020 Jun 26.
The immune response involved in the pathogenesis of Inflammatory Bowel Disease (IBD) may be present years before the diagnosis, but the characteristics of the disease during the preclinical period have been scarcely investigated.
To describe the microscopic findings of preclinical IBD and its relationship with the natural history of the disease.
Medical records from all patients with an incidental diagnosis of IBD during a screening colonoscopy were included in this multicentric and retrospective study. We assessed 15 histologic items in the biopsy samples at diagnosis, and the Geboes score was calculated in patients with Ulcerative Colitis (UC). The main outcome was the development of gastrointestinal symptoms during follow-up.
We included 110 patients (79 UC, 24 Crohn's Disease (CD) and 7 with unclassified disease). In UC the most common histologic findings were acute or chronic inflammatory infiltrate and crypt epithelial polymorphs, while in CD we observed acute or chronic neutrophilic infiltrate and epithelial irregularity. Granuloma were only observed in 4% of CD patients. Crypt distortion and the infiltration of neutrophils in the epithelium were associated with a higher risk of developing symptomatic disease.
Preclinical IBD shows specific microscopic findings and they are associated with the progression to symptomatic disease.
炎症性肠病（IBD）发病机制中的免疫反应可能在诊断前数年就已存在，但疾病的临床前期特征研究甚少。
描述临床前期 IBD 的显微镜下表现及其与疾病自然史的关系。
本多中心回顾性研究纳入了所有在筛查性结肠镜检查中偶然诊断为 IBD 的患者的病历。我们在诊断时评估了活检样本中的 15 项组织学项目，并对溃疡性结肠炎（UC）患者计算 Geboes 评分。主要结局是在随访期间出现胃肠道症状。
我们纳入了 110 名患者（79 名 UC、24 名克罗恩病（CD）和 7 名未分类疾病）。在 UC 中，最常见的组织学发现是急性或慢性炎症浸润和隐窝上皮多形性，而在 CD 中，我们观察到急性或慢性中性粒细胞浸润和上皮不规则。肉芽肿仅在 4%的 CD 患者中观察到。隐窝变形和上皮内中性粒细胞浸润与发生有症状疾病的风险增加相关。
临床前期 IBD 具有特定的显微镜下表现，与进展为有症状疾病相关。
