Envoi Specialist Pathologists.
Faculty of Medicine, University of Queensland.
Adv Anat Pathol. 2022 Jan 1;29(1):25-36. doi: 10.1097/PAP.0000000000000318.
Pathologists have an important and expanding role in the diagnosis and management of inflammatory bowel disease. This role includes the initial diagnosis of the disease, assessment of the response to treatment and the identification of short-term complications such as cytomegalovirus infection and long-term complications such as dysplasia. Furthermore, the assessment of resection specimens for complication of disease is important to determining the risk of subsequent disease or inflammation within an ileal pouch. Adequate sampling of the disease at endoscopy and from the surgical resection specimen is vital to determining the ultimate information that can be provided by the pathologist. This sampling is determined by the clinical scenario. Similarly, a standardized approach to reporting and synthesizing the histologic findings will improve patient management. This is best exemplified by the increasing interest in histologic activity indices, such as the Nancy index in ulcerative colitis, and in the standardized reporting for inflammatory bowel disease dysplasia recommended by the SCENIC international consensus.
病理学家在炎症性肠病的诊断和治疗中发挥着重要且不断扩大的作用。这一角色包括疾病的初步诊断、评估治疗反应以及识别短期并发症（如巨细胞病毒感染）和长期并发症（如发育不良）。此外，评估疾病切除标本的并发症对于确定疾病或回肠袋内炎症的后续风险很重要。内镜和手术切除标本中疾病的充分取样对于确定病理学家可以提供的最终信息至关重要。这种取样取决于临床情况。同样，报告和综合组织学发现的标准化方法将改善患者管理。这一点最好通过对组织学活动指数（如溃疡性结肠炎中的 Nancy 指数）的日益关注以及 SCENIC 国际共识推荐的炎症性肠病发育不良的标准化报告来证明。
