Konuma Y, Tanaka M, Saito H, Munakata A, Yoshida Y
First Department of Internal Medicine, Hirosaki University School of Medicine, Japan.
J Gastroenterol. 1995 Apr;30(2):189-94. doi: 10.1007/BF02348664.
It is clinically important to distinguish idiopathic inflammatory bowel disease (IBD) from other colitides, and ulcerative colitis (UC) from Crohn's disease (CD); however only a few histological criteria based on colonic biopsies have been established. We investigated 209 consecutive series of biopsies taken from 38 patients with UC, 12 with CD, and 105 with other colitides, to evaluate whether combinations of histological features, selected on the basis of our experience, and listed below, could be useful criteria for the differential diagnosis of IBD, and, more specifically, of UC: (A) chronic inflammation with a predominant increase of plasma cells, (B) crypt distortion, (C) crypt atrophy, (D) diffuse chronic inflammation within a biopsy and between biopsies, and (E) diffuse mucin depletion within a biopsy and between biopsies. Findings that fulfilled all or two of A-C distinguished IBD from the other colitides with high sensitivity (94.3%) and specificity (95.8%). When the findings fulfilled the additional criteria of D and/or E, UC was differentiated from CD or the other colitides with high sensitivity (86.4%) and specificity (99.3%).
将特发性炎症性肠病（IBD）与其他结肠炎区分开来，以及将溃疡性结肠炎（UC）与克罗恩病（CD）区分开来在临床上具有重要意义；然而，基于结肠活检的组织学标准却寥寥无几。我们对连续209例活检样本进行了研究，这些样本取自38例溃疡性结肠炎患者、12例克罗恩病患者以及105例患有其他结肠炎的患者，目的是评估根据我们的经验选择的以下组织学特征组合是否可作为IBD（更具体地说是UC）鉴别诊断的有用标准：（A）以浆细胞显著增多为主的慢性炎症，（B）隐窝扭曲，（C）隐窝萎缩，（D）活检样本内及不同活检样本间的弥漫性慢性炎症，以及（E）活检样本内及不同活检样本间的弥漫性粘蛋白缺失。满足A - C中全部或两项特征的结果能够以高敏感性（94.3%）和特异性（95.8%）将IBD与其他结肠炎区分开来。当结果满足D和/或E的附加标准时，能够以高敏感性（86.4%）和特异性（99.3%）将UC与CD或其他结肠炎区分开来。
