Department of Pathology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China.
Department of Gastroenterology, Children's Hospital of Fudan University, Shanghai, China.
J Dig Dis. 2023 Nov;24(11):594-602. doi: 10.1111/1751-2980.13236. Epub 2023 Nov 21.
Intestinal Behçet's disease (BD) predominantly affects the ileocecal region and is currently diagnosed based on endoscopic features and clinical manifestations. It is difficult to distinguish between intestinal BD and Crohn's disease (CD) due to similar patient populations, gastrointestinal involvement, extraintestinal manifestations, and long-term recurrent course. In this study we aimed to compare the clinicopathological and immunophenotypic features of intestinal BD to CD.
The medical and pathological records of 29 cases of intestinal BD and 120 cases of CD diagnosed at Sir Run Run Shaw Hospital were retrospectively analyzed. Immunohistochemistry for CD3, CD20, FOXP3, myeloperoxidase, and quantitative analysis of the infiltrating inflammatory cells was conducted.
Intestinal BD with ileocecal ulcer had a higher incidence of abdominal pain and a higher erythrocyte sedimentation rate than CD, while chronic diarrhea was more common in CD. Excessive neutrophils in the mucosal lamina propria, neutrophilic exudate on the ulcer surface, and prominent lymphocytic infiltration in ulcer tissues were statistically more frequent in intestinal BD than in CD. The numbers of FOXP3 T cells, CD3 T cells, and CD20 B cells in biopsy tissue from intestinal BD were significantly higher than CD, but the ratio of FOXP3 T cells to CD3 T cells was not statistically different.
Besides the typical clinical and endoscopic findings, diagnostic biopsies from the ileocecal region in intestinal BD show some histological and immunophenotypic features that are different from CD, which may be useful in distinguishing these two entities.
肠型贝赫切特病（BD）主要累及回盲部，目前主要根据内镜特征和临床表现进行诊断。由于患者人群、胃肠道受累、肠外表现和长期反复发作等方面的相似性，肠型 BD 与克罗恩病（CD）难以区分。本研究旨在比较肠型 BD 与 CD 的临床病理和免疫表型特征。
回顾性分析了浙江大学医学院附属邵逸夫医院诊断的 29 例肠型 BD 和 120 例 CD 患者的临床和病理资料。采用 CD3、CD20、FOXP3、髓过氧化物酶免疫组化染色，并对浸润性炎症细胞进行定量分析。
与 CD 相比，回盲部溃疡型肠型 BD 腹痛发生率较高，红细胞沉降率较高，而慢性腹泻更为常见。肠型 BD 黏膜固有层中中性粒细胞浸润较多，溃疡表面有中性粒细胞渗出，溃疡组织中淋巴细胞浸润明显，均显著多于 CD。肠型 BD 活检组织中 FOXP3 T 细胞、CD3 T 细胞和 CD20 B 细胞数量显著高于 CD，但 FOXP3 T 细胞与 CD3 T 细胞的比值无统计学差异。
除了典型的临床和内镜表现外，肠型 BD 的回盲部诊断性活检还具有一些与 CD 不同的组织学和免疫表型特征，这可能有助于区分这两种疾病。
