Seldenrijk C A, Hendriks G, Smeulders A W, Baak J P, van Spreeuwel J P, Meuwissen S G, Meijer C J
Department of Pathology, Free University Hospital, Amsterdam, The Netherlands.
Anal Quant Cytol Histol. 1988 Apr;10(2):94-100.
Counting immunoglobulin (Ig)-containing cells in colonic mucosal biopsies can help to objectively support the differential diagnosis of ulcerative colitis and Crohn's disease. Before a method for counting Ig-containing cells can be applied in a clinical setting, however, its reproducibility must be determined. This study investigated the reproducibility of two different methods for counting such cells. The use of a light microscope with an ocular grid resulted in a slightly better reproducibility than did the use of a projection microscope with a graphics tablet. Moreover, the ocular grid method had a higher efficiency. The counting of IgM- and IgG-containing cells had a considerably higher reproducibility than did the counting of IgA-containing cells. To determine the minimal number of cells to be counted in order to ascertain a stabilized mean number of Ig-containing cells, the running means of counts of Ig-containing cells were calculated for two observers. When at least 600 Ig-containing cells (i.e., two to four fields) were counted, the interobserver variation of the running means was less than 10% for IgA and IgG counts and less than 5% for IgM counts. Since earlier studies showed differences in the counts of IgA-, IgG- and IgM-containing cells between ulcerative colitis and Crohn's disease to be, respectively, 3%, 25% and 28%, the results of the present study suggest that the proposed counting method can be useful in the differentiation between these entities.
对结肠黏膜活检组织中含免疫球蛋白（Ig）的细胞进行计数，有助于客观辅助溃疡性结肠炎和克罗恩病的鉴别诊断。然而，在将一种含Ig细胞计数方法应用于临床之前，必须先确定其可重复性。本研究调查了两种不同的此类细胞计数方法的可重复性。使用带有目镜网格的光学显微镜，其可重复性略优于使用带有数位绘图板的投影显微镜。此外，目镜网格法效率更高。对含IgM和IgG细胞的计数，其可重复性显著高于对含IgA细胞的计数。为确定为确定含Ig细胞稳定平均数而需计数的最少细胞数，计算了两名观察者对含Ig细胞计数的移动平均值。当计数至少600个含Ig细胞（即两到四个视野）时，对于IgA和IgG计数，观察者间移动平均值的差异小于10%，对于IgM计数则小于5%。由于早期研究表明，溃疡性结肠炎和克罗恩病之间含IgA、IgG和IgM细胞的计数差异分别为3%、25%和28%，本研究结果表明，所提出的计数方法可能有助于区分这两种疾病。
