摘要
目的 探讨克隆病 (crohn’sdisease ,CD)肠粘膜上皮增生、异型增生、癌变的临床病理特点及意义。方法 收集 5例CD患者的临床病理资料 ,光镜观察肠粘膜活检及手术肠切除的病理组织学特点 ,应用国际炎性肠病的分类标准对上皮增生进行分类 ,部分切片行CEA、PCNA免疫组化染色。结果 3例肠粘膜活检未发现特异性病变。 5例手术标本均可见非干酪样坏死肉芽肿或巨细胞 ;3例有典型裂隙状溃疡形成。 4例次上皮有局灶未定型异型增生 ,2例有局灶异型增生 ,1例小灶癌变。结论 本文报告的 5例CD术前肠粘膜活检缺乏组织学特异性 ,需与UC及其他炎性肠病鉴别。伴发异型增生和癌变没有典型的肉眼特征 ,易与炎症及其他病变相混淆而忽略。炎性肠病异型增生的新分类 ,为CD患者的监护、治疗及预后提供了更为详细的病理学资料。“未定型异型增生”组织学标准。
Objective To investigate the clinicopathological features of dysplasia and carcinoma in Crohn's disease. Methods Clinical data, histologic characteristics, especially the degree of epithelial proliferation, and immunostainings of CEA and PCNA were analyzed in 5 cases of Crohn's disease . Results Biopsies of colonic mucosa in 3 cases showed that severe inflammation and no specific lesions. Non-caseous granulomas and/or multinucleated giant cells were conspicuous in surgical resected specimen of all cases, with linear ulcers in 3 cases. Indefinable focal dysplasia was found in 3 cases, adenocarcinoma in one case. There were no differences in the expression of CEA and PCNA in the proliferative epithelia. Conclusion Crohn's disease complicating dysplasia and carcinoma is short of typical macroscopic features and easily confused with inflammatory bowel diseases. The new classification of dysplasia in the disease would provide more useful information for surveillance, prognosis and treatment of the patients.
出处
《诊断病理学杂志》
CSCD
2000年第2期99-102,I023,共5页
Chinese Journal of Diagnostic Pathology
