Hill R B, Kent T H, Hansen R N
Gastroenterology. 1979 Oct;77(4 Pt 2):938-44.
Initial rectal biopsies from 349 patients judged on clinical, radiologic, or pathologic grounds to have Crohn's disease were studied, and findings were compared with a variety of clinical varibles. Biopsies from only 54 patients (15% of total) contained histologic changes characteristic of Crohn's disease, and all but one of these were previously known to have colonic involvement. Yield of diagnostic findings was directly associated with the presence of sigmoidoscopic or radiologic abnormality in the distal colon or rectum. Minor, nondiagnostic abnormalities were more common. It is concluded that routine single rectal biopsy in unselected cases of Crohn's disease has limited diagnostic value under usual conditions of practice, and that histologic abnormalities are most likely to be found in patients with known colonic, and especially sigmoid and rectal involvement.
对349例根据临床、放射学或病理学依据判断患有克罗恩病的患者进行了初始直肠活检，并将结果与多种临床变量进行了比较。仅54例患者（占总数的15%）的活检标本含有克罗恩病的特征性组织学改变，其中除1例之外，其余患者此前均已知有结肠受累情况。诊断性结果的检出率与乙状结肠镜或远端结肠或直肠的放射学异常直接相关。轻微的、非诊断性异常更为常见。得出的结论是，在常规临床实践条件下，对未经挑选的克罗恩病病例进行常规单次直肠活检的诊断价值有限，并且组织学异常最有可能在已知有结肠受累，尤其是乙状结肠和直肠受累的患者中发现。
