Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA.
Department of Pathology, Moffitt Cancer Center, Tampa, FL.
Adv Anat Pathol. 2022 Jan 1;29(1):37-47. doi: 10.1097/PAP.0000000000000326.
Histology is used to confirm the diagnosis of inflammatory bowel disease, exclude superimposed infections, and to evaluate for dysplasia. Histology has rarely been used to measure disease activity and guide therapy despite evidence that histologic measurements have value in predicting important clinical outcomes. More recently, there have been numerous studies supporting a role for histologic disease activity measurements in predicting a variety of outcomes including relapse, hospitalizations, steroid use, and dysplasia. The histologic assessment was superior to endoscopic measurements in many of these studies. This review will summarize the recent literature regarding histologic disease activity measurements in ulcerative colitis and Crohn disease. A detailed description of histologic scoring systems will also be provided to provide pathologists with the necessary tools to accurately measure disease activity.
组织学用于确认炎症性肠病的诊断，排除合并感染，并评估异型增生。尽管有证据表明组织学测量值对预测重要的临床结局具有价值，但组织学很少用于衡量疾病活动并指导治疗。最近，有许多研究支持组织学疾病活动测量在预测各种结局中的作用，包括复发、住院、使用类固醇和异型增生。在这些研究中，组织学评估在许多方面优于内镜测量。本综述将总结溃疡性结肠炎和克罗恩病中组织学疾病活动测量的最新文献。还将详细描述组织学评分系统，为病理学家提供准确测量疾病活动所需的工具。
