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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、转归有待进一步观察研究
Objective To investigate the clinicopathological features and significance of intestinal epithelial proliferation, dysplasia and carcinogenesis in Crohn’s disease (CD). Methods The clinicopathological data of 5 CD patients were collected. The histopathological features of intestinal mucosal biopsy and intestinal resection were observed by light microscopy. Epidermal hyperplasia was classified according to the international classification of inflammatory bowel disease. Some sections were performed immunohistochemistry CEA and PCNA Staining. Results No intestinal lesions were found in 3 cases of intestinal mucosal biopsy. Non-caseous necrotizing granulomas or giant cells were observed in 5 cases of surgical specimens, and typical fractures of ulcers were found in 3 cases. 4 cases of sub-epithelial focal non-stereotyped hyperplasia, 2 cases of focal dysplasia, 1 case of small lesions. Conclusions The five cases of preoperative CD mucosal biopsy of CD presented here lack of histological specificity and need to be differentiated from UC and other inflammatory bowel diseases. Accompanying dysplasia and cancers do not have typical macroscopic features that are easily confused with inflammation and other pathologies and neglected. A new classification of inflammatory bowel disease has provided more detailed pathological data for the monitoring, treatment and prognosis of patients with CD. “Undefined dysplasia” histological criteria, prognosis pending further observation and study