Surawicz C M, Belic L
Gastroenterology. 1984 Jan;86(1):104-13.
A retrospective blind evaluation of rectal biopsy specimens from 44 patients with acute self-limited colitis and 104 patients with idiopathic inflammatory bowel disease was done. Seven histologic features proved highly discriminant because they occurred often in idiopathic inflammatory bowel disease but rarely, if at all, in acute self-limited colitis. The features with a high predictive probability (87%-100%) of diagnosing idiopathic inflammatory bowel disease were distorted crypt architecture, increased numbers of both round cells and neutrophils in the lamina propria, a villous surface, epithelioid granuloma, crypt atrophy, basal lymphoid aggregates, and basally located isolated giant cells. One or more of these features was present in 79% of all idiopathic inflammatory bowel disease cases. They were seen in both acute and chronic idiopathic inflammatory bowel disease. The biopsy features favoring acute self-limited colitis were less useful. Biopsy diagnosis of acute self-limited colitis is thus primarily based on the absence of histologic criteria favoring idiopathic inflammatory bowel disease. This study provides objective validation of histologic criteria in rectal biopsy that help differentiate acute self-limited colitis from idiopathic inflammatory bowel disease.
对44例急性自限性结肠炎患者和104例特发性炎症性肠病患者的直肠活检标本进行了回顾性盲法评估。七种组织学特征具有高度鉴别性，因为它们在特发性炎症性肠病中经常出现，但在急性自限性结肠炎中很少出现（如果有的话）。诊断特发性炎症性肠病的预测概率较高（87%-100%）的特征包括隐窝结构扭曲、固有层中圆形细胞和中性粒细胞数量增加、绒毛表面、上皮样肉芽肿、隐窝萎缩、基底淋巴聚集以及基底部位的孤立巨细胞。所有特发性炎症性肠病病例中有79%存在这些特征中的一种或多种。它们在急性和慢性特发性炎症性肠病中均可见。有利于急性自限性结肠炎的活检特征作用较小。因此，急性自限性结肠炎的活检诊断主要基于缺乏支持特发性炎症性肠病的组织学标准。本研究为直肠活检中的组织学标准提供了客观验证，有助于区分急性自限性结肠炎和特发性炎症性肠病。
