Institute of Pathology, Friedrich-Alexander-University Erlangen-Nuremberg, Klinikum Bayreuth GmbH, Bayreuth, Germany
Department of Pathology, Karolinska Institute and University Hospital, Stockholm, Sweden.
Anticancer Res. 2022 Jan;42(1):147-154. doi: 10.21873/anticanres.15468.
BACKGROUND/AIM: This study aimed to validate the inter-rater agreement of the assessment of crypt branching (also called crypt fission) in patients with ulcerative colitis (UC) and to elucidate its potential diagnostic and prognostic impact.
A total of 100 biopsies from patients with UC were analyzed. Two cohorts of 50 patients each served as controls [infectious controls/controls with low grade intraepithelial neoplasia (LGIN) in UC alio loco]. Three pathologists scored the number of total crypts in fission as well as the number of crypts in symmetric (CSF) and asymmetric fission (CAF).
Inter-rater agreement ranged from good to excellent in the study cohort. The number of crypts in fission correlated significantly with UC-activity (p=0.001; p<0.001). The study cohort showed higher mean counts of crypts in fission and significant more total and CAF than the infectious controls (p=0.007 and p=0.008), especially in male patients (p<0.001) The LGIN-control cohort showed significant more CSF (p=0.012).
Inter-rater agreement for crypt branching was reliable in the study cohort. Crypt branching proved as an additional histologic feature to distinguish active UC against infectious colitis. Higher amounts of CSF may help identifying patients at higher risk for neoplasia.
背景/目的：本研究旨在验证溃疡性结肠炎（UC）患者中隐窝分支（也称为隐窝裂变）评估的观察者间一致性，并阐明其潜在的诊断和预后影响。
共分析了 100 例 UC 患者的活检标本。两个 50 例患者队列作为对照[感染对照/UC 异部位低级别上皮内瘤变（LGIN）对照]。三名病理学家对裂变中的总隐窝数量以及对称裂变（CSF）和不对称裂变（CAF）中的隐窝数量进行评分。
在研究队列中，观察者间的一致性从良好到极好。裂变中的隐窝数量与 UC 活动度显著相关（p=0.001;p<0.001）。与感染对照相比，研究队列的裂变中隐窝数量更高，总隐窝和 CAF 更多（p=0.007 和 p=0.008），尤其是男性患者（p<0.001），LGIN 对照队列的 CSF 明显更多（p=0.012）。
在研究队列中，隐窝分支的观察者间一致性可靠。隐窝分支被证明是一种额外的组织学特征，可用于区分活动性 UC 与感染性结肠炎。较高数量的 CSF 可能有助于识别具有更高肿瘤风险的患者。
