Ambroze W L, Pemberton J H, Dozois R R, Carpenter H A, O'Rourke J S, Ilstrup D M
Section of Colon and Rectal Surgery, Mayo Clinic, Rochester, Minnesota.
Gastroenterology. 1993 Feb;104(2):514-8. doi: 10.1016/0016-5085(93)90421-8.
The aim was to determine whether the transitional epithelium (TE) of the anal transition zone (ATZ) was involved by chronic ulcerative colitis (CUC) and whether preserving the ATZ preserves the disease.
Proctocolectomy specimens from 50 CUC patients and 50 patients with rectal cancer serving as controls were stained with alcian-blue to map the ATZ, and biopsy specimens containing adjacent TE and rectal mucosa were examined.
The mean inflammation score (0, none; 4, severe) in TE of controls was 0.4, whereas in CUC it was 0.5. However, the mean inflammation score of the rectal mucosa within the ATZ was 0.2 in controls and 2.6 in CUC (P < 0.001). Rectal columnar epithelium extended past half of the maximum length of TE in 75% of patients (65-83%; 95% CI) and was within 1 cm of the dentate line in 89% (81%-94%).
Although the TE of the ATZ was not inflamed, the rectal mucosa within the ATZ was. Moreover, rectal mucosa traversed half of the length of the ATZ in 75% of patients and was within 1 cm of the dentate line in fully 89%. Preserving the ATZ may preserve the disease in the majority of patients with CUC.
目的是确定肛门移行区（ATZ）的移行上皮（TE）是否受慢性溃疡性结肠炎（CUC）累及，以及保留ATZ是否能控制病情。
对50例CUC患者及50例直肠癌患者（作为对照）的直肠结肠切除标本用阿尔辛蓝染色以标记ATZ，并检查包含相邻TE和直肠黏膜的活检标本。
对照组TE的平均炎症评分（0分，无炎症；4分，重度炎症）为0.4，而CUC组为0.5。然而，ATZ内直肠黏膜的平均炎症评分在对照组为0.2，在CUC组为2.6（P<0.001）。75%（65%-83%；95%CI）的患者直肠柱状上皮延伸超过TE最大长度的一半，89%（81%-94%）的患者其距齿状线在1cm以内。
虽然ATZ的TE未发生炎症，但ATZ内的直肠黏膜有炎症。此外，75%的患者直肠黏膜穿过ATZ长度的一半，89%的患者其距齿状线在1cm以内。保留ATZ可能使大多数CUC患者的病情得到控制。
