Rosekrans P C, Meijer C J, Polanco I, Mearin M L, van der Wal A M, Lindeman J
J Clin Pathol. 1981 Feb;34(2):138-44. doi: 10.1136/jcp.34.2.138.
Jejunal biopsy specimens from nine Spanish children with gluten-sensitive enteropathy were studied with morphometric and immunohistochemical techniques in three stages of the diseases: the first biopsy was taken for diagnosis, when the child had a gluten-containing diet, the second after gluten withdrawal, and the third biopsy after gluten-provocation. The findings were compared with those in 10 healthy adults. The villous:crypt ratio and the length of the surface epithelium per stretched millimetre muscularis mucosae were decreased, whereas the number of interepithelial lymphocytes per millimetre surface epithelium was increased when the child had a gluten-containing diet. Although these parameters improved after withdrawal of gluten for at least seven months, they never reached the values of the healthy control group. With the indirect immunoperoxidase technique it was shown that the numbers of IgA-, IgG-, and IgM-containing cells, expressed per "mucosal tissue unit" of 4 micrometer thick and 1 mm wide, were significantly increased during the active phases of the disease. This increase was most striking for the IgM-containing cells. The most sensitive parameters for the histological diagnosis of gluten-sensitive enteropathy are the villous:crypt ratio or the length of the surface epithelium per millimetre muscularis mucosae, the number of interepithelial lymphocytes per millimetre surface epithelium, and the number of IgM-containing cells per millimetre muscularis mucosae.
对9名患有麸质敏感性肠病的西班牙儿童的空肠活检标本，采用形态计量学和免疫组织化学技术，在疾病的三个阶段进行了研究：第一次活检在诊断时进行，此时儿童食用含麸质饮食；第二次活检在停用麸质后进行；第三次活检在麸质激发后进行。将研究结果与10名健康成年人的结果进行比较。当儿童食用含麸质饮食时，绒毛与隐窝比值以及每伸展毫米黏膜肌层的表面上皮长度降低，而每毫米表面上皮的上皮内淋巴细胞数量增加。尽管在停用麸质至少7个月后这些参数有所改善，但它们从未达到健康对照组的值。采用间接免疫过氧化物酶技术显示，在疾病的活跃期，每4微米厚、1毫米宽的“黏膜组织单位”中含IgA、IgG和IgM的细胞数量显著增加。含IgM的细胞增加最为显著。麸质敏感性肠病组织学诊断最敏感的参数是绒毛与隐窝比值或每毫米黏膜肌层的表面上皮长度、每毫米表面上皮的上皮内淋巴细胞数量以及每毫米黏膜肌层含IgM的细胞数量。
