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内镜活检Crohn病的临床病理分析

Endoscopic biopsy of Crohn's disease:a clinicopathological Study

来源期刊: 广州医药 | 52-56 发布时间:2021-12-21 收稿时间:2025/11/13 17:37:38 阅读量:20
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关键词:
Crohn病内镜活检肉芽肿裂隙状溃疡免疫组织化学
Crohn diseaseEndoscopy biopsyGranulomaFissure ulcerImmunohistochemistry
DOI:
10.3969/j.issn.1000-8535.2019.01.013
收稿时间:
2018-09-07 
修订日期:
 
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0  
目的 探讨内镜活检Crohn病(CD)的临床病理特征,为临床提供更可靠的诊断。方法 回顾性分析内镜活检12例CD的临床表现、内窥镜特征,采用HE染色及免疫组化EnVision二步法。结果 显微镜下CD的组织学形态主要特征是非干酪样坏死性肉芽肿、裂隙状溃疡、黏膜及黏膜下层不均匀分布的重度炎症,淋巴管扩张和纤维组织增生,免疫组化染色CD68、D2-40、S-100均表达。结论 CD是一肿少见的炎症性肠病,回盲部及末段回肠是最好发部位,主要表现反复腹泻、血便等症状,内镜下见多灶溃疡,不连续性病变等特征,组织学见裂隙性溃疡,黏膜及黏膜下层的重度炎症且不均匀分布,位于生发中心的非干酪结节病样肉芽肿、淋巴管扩张和纤维组织增生等非特异性特征,可靠的病理诊断要结合临床、内镜、影像等检查及多部位多次活检。
Objective To investigate the clinical and pathological features of endoscopic biopsy tissue of Crohn disease (CD) and further to provide more reliable evidence for clinic. Methods A retrospective analysis of 12 cases of endoscopic biopsy tissue about CD’s clinical manifestations and endoscopic features,by HE staining and immunohistochemistry EnVision two-step method. Results The morphology of CD specimen is characterized by non-caseous necrotizing granuloma,ulceration,mucosal and submucosal uneven distribution of severe inflammation,dilated lymph vessels and fibrous hyperplasia. Immunohistochemical staining , all of cases express CD68,D2-40 and S-100. Conclusion CD is a rare inflammatory bowel disease. The majority of CD arises in ileocecal and terminal ileum. The main symptoms show repeated diarrhea,bloody stool and others. Endoscopic examination revealed multifocal ulcers,discontinuous lesions and other characteristics. Histological examination showed that there were nonspecific features such as fissure ulcer,severe inflammation in mucosa and submucosa with uneven distribution,non-caseous sarcoid-like granuloma in the germinal center,lymphangiectasis and fibrous tissue hyperplasia. An reliable pathological diagnosis is made that depends on many examinations including clinical,endoscope,radiology and multiple biopsy.
1、 LIU Y Y,CHEN M K,CAO Z,et al.Differential diagnosis of intestinal tuberculosis from Crohn's disease and primary intestinal lymphoma in China[J]. Saudi J Gastroenterol,2014,20(4):241-247. LIU Y Y,CHEN M K,CAO Z,et al.Differential diagnosis of intestinal tuberculosis from Crohn's disease and primary intestinal lymphoma in China[J]. Saudi J Gastroenterol,2014,20(4):241-247.
2、 HUANG X,LIAO W D,YU C,et al.Differences in clinical features of Crohn's disease and intestinal tuberculosis[J]. World J Gastroenterol,2015,21(12):3650-3656. HUANG X,LIAO W D,YU C,et al.Differences in clinical features of Crohn's disease and intestinal tuberculosis[J]. World J Gastroenterol,2015,21(12):3650-3656.
3、 SHARMA R,MADHUSUDHAN K S,AHUJA V.Intestinal tuberculosis versus crohn's disease:Clinical and radiological recommendations[J]. Indian J Radiol Imaging,2016,26(2):161-172. SHARMA R,MADHUSUDHAN K S,AHUJA V.Intestinal tuberculosis versus crohn's disease:Clinical and radiological recommendations[J]. Indian J Radiol Imaging,2016,26(2):161-172.
4、 BURGER M,SCHMIDT C,TEICH N,et al.Medical therapy of active ulcerative colitis[J]. Viszeralmedizin,2015,31(4):236-245. BURGER M,SCHMIDT C,TEICH N,et al.Medical therapy of active ulcerative colitis[J]. Viszeralmedizin,2015,31(4):236-245.
5、 BRESSENOT A M,RIDDELL R H,BOULAGNON-ROMBI C,et al.Review article:the histological assessment of disease activity in ulcerative colitis[J]. Aliment Pharmacol Ther ,2015,42(8):957-967. BRESSENOT A M,RIDDELL R H,BOULAGNON-ROMBI C,et al.Review article:the histological assessment of disease activity in ulcerative colitis[J]. Aliment Pharmacol Ther ,2015,42(8):957-967.
6、 FERNANDO GOMOLLóN,AXEL DIGNASS,VITO ANNESE,et al.3rd European evidence-based consensus on the diagnosis and management of Crohn’s disease 2016:Part 1:diagnosis and medical management[J]. J Crohn's Colitis,2015,4(1):7. FERNANDO GOMOLLóN,AXEL DIGNASS,VITO ANNESE,et al.3rd European evidence-based consensus on the diagnosis and management of Crohn’s disease 2016:Part 1:diagnosis and medical management[J]. J Crohn's Colitis,2015,4(1):7.
7、 MAGRO F,LANGNER C,DRIESSEN A,et al.European consensus on the histopathology of inflammatory bowel disease[J]. J Crohns Colitis,2013,7(10):827-851. MAGRO F,LANGNER C,DRIESSEN A,et al.European consensus on the histopathology of inflammatory bowel disease[J]. J Crohns Colitis,2013,7(10):827-851.
8、 VAVRICKA SR,SPIGAGLIA SM,ROGLER G,et al.Systematic evaluation of risk factors for diagnostic delay in inflammatory bowel disease[J]. Inflamm Bowel Dis,2012,18(3):496-505. VAVRICKA SR,SPIGAGLIA SM,ROGLER G,et al.Systematic evaluation of risk factors for diagnostic delay in inflammatory bowel disease[J]. Inflamm Bowel Dis,2012,18(3):496-505.
9、 ARATARI A,PAPI C,GALLETTI B,et al.Seasonal variations in onset of symptoms in Crohn's disease[J]. Dig Liver Dis,2006,38(5):319-323. ARATARI A,PAPI C,GALLETTI B,et al.Seasonal variations in onset of symptoms in Crohn's disease[J]. Dig Liver Dis,2006,38(5):319-323.
10、 Xiong H F,Wang B,Zhao Z H,et al. Tonsillectomy and inflammatory bowel disease:a meta-analysis[J]. Colorectal Dis,2016,18(5):O145- O 153. Xiong H F,Wang B,Zhao Z H,et al. Tonsillectomy and inflammatory bowel disease:a meta-analysis[J]. Colorectal Dis,2016,18(5):O145- O 153.
11、 ANANTHAKRISHNAN A N,CHENG A,CAGAN A,et al.Mode of childbirth and long-term outcomes in women with inflammatory bowel diseases[J]. Dig Dis Sci,2015,60(2):471-477. ANANTHAKRISHNAN A N,CHENG A,CAGAN A,et al.Mode of childbirth and long-term outcomes in women with inflammatory bowel diseases[J]. Dig Dis Sci,2015,60(2):471-477.
12、 MARTIN J,KANE SV,FEAGINS L A.Fertility and contraception in women with inflammatory bowel disease[J]. Gastroenterol Hepatol (N Y),2016,12(2):101-109. MARTIN J,KANE SV,FEAGINS L A.Fertility and contraception in women with inflammatory bowel disease[J]. Gastroenterol Hepatol (N Y),2016,12(2):101-109.
13、 ZULLOW S,JAMBAULIKAR G,RUSTGI A,et al.Risk factors for vitamin D deficiency and impact of repletion in a tertiary care inflammatory bowel disease population[J]. Gastroenterol , 2012 , 142(5) :1-7. ZULLOW S,JAMBAULIKAR G,RUSTGI A,et al.Risk factors for vitamin D deficiency and impact of repletion in a tertiary care inflammatory bowel disease population[J]. Gastroenterol , 2012 , 142(5) :1-7.
14、 SONG EM,SEO M,Hwang S W,et al.Assessment of factors associated with smoking cessation at diagnosis or during follow-up of Crohn's disease[J]. J Gastroenterol Hepatol ,2018,33(1):180-186. SONG EM,SEO M,Hwang S W,et al.Assessment of factors associated with smoking cessation at diagnosis or during follow-up of Crohn's disease[J]. J Gastroenterol Hepatol ,2018,33(1):180-186.
15、 MAASER CHRISTIAN,LANGHOLZ EBBE,B GORDON HANNAH,et al. European Crohn’s and colitis organisation topical review on environmental factors in IBD[J]. J Crohn's Colitis,2016,11(8):905-920. MAASER CHRISTIAN,LANGHOLZ EBBE,B GORDON HANNAH,et al. European Crohn’s and colitis organisation topical review on environmental factors in IBD[J]. J Crohn's Colitis,2016,11(8):905-920.
16、 SHEN Z,ZHU C,QUAN Y,et al.Update on intestinal microbiota in Crohn's disease 2017:mechanisms,clinical application,adverse reactions,and outlook[J]. J Gastroenterol Hepatol,2017,32(11):1804-1812. SHEN Z,ZHU C,QUAN Y,et al.Update on intestinal microbiota in Crohn's disease 2017:mechanisms,clinical application,adverse reactions,and outlook[J]. J Gastroenterol Hepatol,2017,32(11):1804-1812.
17、 MOSLI M,BESHIR M A L,AL-JUDAIBI B,et al. Advances in the diagnosis and management of inflammatory bowel disease:challenges and uncertainties[J]. Saudi J Gastroenterol ,2014,20(2):81-101. MOSLI M,BESHIR M A L,AL-JUDAIBI B,et al. Advances in the diagnosis and management of inflammatory bowel disease:challenges and uncertainties[J]. Saudi J Gastroenterol ,2014,20(2):81-101.
18、 SANDBORN W,COLOMBEL J F,D'HAENS G,et al. The Crohn's disease-ulcerative colitis clinical appraisal update:emerging trends in clinical practice[J]. Clin Gastroenterol Hepatol,2016,14(9):e121-122. SANDBORN W,COLOMBEL J F,D'HAENS G,et al. The Crohn's disease-ulcerative colitis clinical appraisal update:emerging trends in clinical practice[J]. Clin Gastroenterol Hepatol,2016,14(9):e121-122.
19、 SOBRADO C W,LEAL R F,SOBRADO L F.THERAPIES FOR CROHN'S DISEASE:A clinical update[J]. Arq Gastroenterol ,2016,53(3):206-211. SOBRADO C W,LEAL R F,SOBRADO L F.THERAPIES FOR CROHN'S DISEASE:A clinical update[J]. Arq Gastroenterol ,2016,53(3):206-211.
20、 ZORZI F,CALABRESE E,MONTELEONE G.Pathogenic aspects and therapeutic avenues of intestinal fibrosis in Crohn's disease[J]. Clin Sci (Lond) ,2015,129(12):1107-1113. ZORZI F,CALABRESE E,MONTELEONE G.Pathogenic aspects and therapeutic avenues of intestinal fibrosis in Crohn's disease[J]. Clin Sci (Lond) ,2015,129(12):1107-1113.
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