Jenkins D, Goodall A, Drew K, Scott B B
Department of Pathology, Whittington Hospital, London.
J Clin Pathol. 1988 Jan;41(1):72-9. doi: 10.1136/jcp.41.1.72.
Measurements of mucosal dimension, architecture, and cell counts in both lamina propria and epithelium were made on rectal biopsy specimens from 20 patients with irritable bowel syndrome ("normal" controls); 54 patients with ulcerative colitis, Crohn's disease, and non-specific proctitis; eight patients with small bowel Crohn's disease; and 34 in whom the rectal biopsy specimen was not diagnostic. Discriminant analysis was applied to multiple variables based on the measurements, and three variables were identified as of high predictive value. The most powerful discriminant was increased lamina propria cellularity in all forms of chronic colitis. The ratios of surface length to mucosal length and of surface epithelial height to crypt epithelial height also emerged as discriminants. Chronic inflammatory bowel disease was distinguished from normal in 95% of cases with a definite pathological diagnosis, and 85% of borderline cases were correctly classified as either normal or inflammatory when judged by the final diagnosis after follow up. This study provides a basis for automated diagnosis of rectal biopsy specimens and provides objectively validated criteria which can also be applied in routine histological diagnosis.
对20例肠易激综合征患者（“正常”对照）、54例溃疡性结肠炎、克罗恩病和非特异性直肠炎患者、8例小肠克罗恩病患者以及34例直肠活检标本未明确诊断的患者的直肠活检标本进行了黏膜尺寸、结构以及固有层和上皮细胞计数的测量。基于这些测量结果，对多个变量进行判别分析，确定了三个具有高预测价值的变量。最有力的判别指标是所有形式的慢性结肠炎中固有层细胞增多。表面长度与黏膜长度之比以及表面上皮高度与隐窝上皮高度之比也成为判别指标。在95%具有明确病理诊断的病例中，慢性炎症性肠病与正常情况得以区分，并且在随访后的最终诊断判断中，85%的临界病例被正确分类为正常或炎症性疾病。本研究为直肠活检标本的自动诊断提供了依据，并提供了经过客观验证的标准，这些标准也可应用于常规组织学诊断。
