Cook M G, Dixon M F
Gut. 1973 Apr;14(4):255-62. doi: 10.1136/gut.14.4.255.
Two pathologists have independently applied 95 separate pathological criteria to 50 cases of inflammatory large bowel disease firmly diagnosed clinically as 25 cases of Crohn's disease and 25 cases of ulcerative colitis. The observer agreement in the recording of each feature has been calculated and correlations have been made between the pathological features and the final agreed diagnosis in order to obtain an estimate of the value of each feature in differential diagnosis. The features which have been found to be most accurately observed and useful in the diagnosis of Crohn's disease include confluent linear ulcers, deep fissures, an aggregated inflammatory pattern, and sarcoid-like granulomata. The features which have been shown to be most accurate and valuable in the diagnosis of ulcerative colitis include a ;healed granular' mucosa, a continuous inflammatory pattern, an irregular gland pattern, and the absence of fissures. The authors consider that the use of such accurate and valuable pathological criteria in the examination of inflammatory bowel disease would facilitate retrospective correlation with the clinical findings and help to clarify those intermediate cases which are at present a source of diagnostic difficulty.
两位病理学家独立地将95项不同的病理标准应用于50例临床上确诊为炎症性大肠疾病的病例，其中25例为克罗恩病，25例为溃疡性结肠炎。计算了每位观察者对每个特征记录的一致性，并对病理特征与最终达成共识的诊断结果进行了相关性分析，以便评估每个特征在鉴别诊断中的价值。已发现对克罗恩病诊断最准确且有用的特征包括融合性线性溃疡、深部裂隙、聚集性炎症模式和类肉瘤样肉芽肿。已证明对溃疡性结肠炎诊断最准确且有价值的特征包括“愈合颗粒状”黏膜、连续性炎症模式、不规则腺体模式以及无裂隙。作者认为，在炎症性肠病检查中使用此类准确且有价值的病理标准将有助于与临床发现进行回顾性关联，并有助于阐明目前诊断困难的中间病例。
