Department of Pathology, Karolinska Institute, Stockholm, Sweden
Department of Medicine (Solna), Karolinska Institute, Ersta Hospital, Stockholm, Sweden.
J Clin Pathol. 2021 Sep;74(9):577-581. doi: 10.1136/jclinpath-2020-206694. Epub 2020 Dec 16.
We previously found colonic crypts with asymmetric fission bordering regenerating ulcers in ulcerative colitis (UC). The present objective was to assess the frequency of asymmetric crypt-fission in colectomy specimens from patients with long-lasting UC.
H&E-stained sections from seven colectomies from patients with UC without dysplasia or carcinoma were investigated. Symmetric fission was characterised by branched colon crypts showing ≥2 identical crypts, whereas asymmetric fission exhibited branched colon crypt portraying ≥2 dissimilar crypts, differing in diameter, length and/or shape.
The number of crypts in fission in the 89 sections was 3586; of those, 2930 (81.7%) were asymmetric and the remaining 656 (18.3%), symmetric. Out of 927 vertically-cut crypts (in well-oriented sections), 912 (98.4%) were asymmetric, and the remaining 14 (1.6%), symmetric, and out 2660, cross-cut (transected) crypts in fission, 2018 (75.9%) were asymmetric and the remaining 642 (24.1%), symmetric.
Crypt fission is rarely found in the normal colon in adults. Symmetric crypt fission found in UC is possibly triggered by a compensatory homeostatic mechanism of crypt production in mucosal areas replaced by chronic inflammation. But asymmetric crypt fission is a pathological aberration that affects crypts in patients with a particular predisposition to develop mucosal dysplasia. It is suggested that this previously unattended histological parameter be included in the pathological descriptions of colectomy specimens from patients with UC.
我们之前在溃疡性结肠炎（UC）中发现了具有边界再生溃疡的不对称分裂的结肠隐窝。本研究旨在评估在具有长期 UC 的患者的结肠切除标本中不对称隐窝分裂的频率。
研究了 7 例无发育不良或癌的 UC 结肠切除术标本的 H&E 染色切片。对称分裂的特征是分支结肠隐窝显示≥2 个相同的隐窝，而不对称分裂则显示分支结肠隐窝描绘了≥2 个不同的隐窝，在直径、长度和/或形状上存在差异。
在 89 个切片中，分裂的隐窝数量为 3586 个；其中，2930 个（81.7%）为不对称分裂，其余 656 个（18.3%）为对称分裂。在 927 个垂直切割的隐窝（在定向良好的切片中）中，912 个（98.4%）为不对称分裂，其余 14 个（1.6%）为对称分裂，在 2660 个横切（横切）分裂的隐窝中，2018 个（75.9%）为不对称分裂，其余 642 个（24.1%）为对称分裂。
成人正常结肠中很少发现隐窝分裂。在 UC 中发现的对称隐窝分裂可能是由慢性炎症替代的黏膜区域中隐窝产生的补偿性稳态机制触发的。但是，不对称隐窝分裂是一种病理异常，影响具有特定黏膜发育不良倾向的患者的隐窝。建议将这一以前未被关注的组织学参数纳入 UC 患者结肠切除标本的病理描述中。
