摘要
目的:探讨克罗恩病(Crohn's disease,CD)和肠结核(intestinal tuberculosis,ITB)活检及手术标本的病理学特征在二者鉴别诊断中的价值.方法:选取在湘雅二医院、湘雅医院、湘西自治州人民医院确诊的CD和ITB患者各55例,其中活检标本各55例;手术病理标本CD29例,手术ITB9例.统计每例标本的病理学特征并进行比较.结果:CD患者活检标本与ITB患者活检标本比较,黏膜下层增宽、裂隙状溃疡及肉芽肿差异均有统计学意义(37.5%vs14.0%,10.9%vs0%,10.9%vs43.6%,均P<0.05);手术标本比较,黏膜下层增宽、裂隙状溃疡、固有肌层增厚、鹅卵石征及肉芽肿差异均有统计学意义(51.7%vs11.1%,34.5%vs0%,62.1%vs11.1%,37.9%vs0%,20.7%vs77.8%,均P<0.05).结论:活检标本的病理学特征鉴别CD和ITB价值有限,手术标本病理学特征对他们有鉴别价值,但仍需结合临床、内镜及影像学检查综合诊断.
AIM： To explore the distinctive diagnostic features of biopsy and operative specimens between Crohn＇s disease and intestinal tuberculosis. METHODS： A retrospective study was performed to analyze the pathological features of 110 biopsy specimens （55 from patients with Crohn＇s disease, and 55 from patients with intestinal tuberculosis） and 38 operative specimens （29 from patients with Crohn＇s disease, and 9 from patients with intestinal tuberculosis）. The value of these pathological features in differential diagnosis of the two diseases was analyzed.RESULTS： Pathologic parameters of biopsy specimens helpful in differentiating Crohn＇s disease from intestinal tuberculosis included broadened submucosa, fissure-like ulcer, and granuloma （37.5% vs 14.0%, 10.9% vs 0%, and 10.9% vs 43.6%, respectively; all P 〈 0.05）. Pathologic parameters of operative specimens helpful in differentiating Crohn＇s disease from intestinal tuberculosis included broadened submucosa, fissure-like ulcer, broadened muscularis propria, cobblestone appearance, and granuloma （51.7% vs 11.1%, 34.5% vs 0%, 62.1% vs 11.1%, 37.9% vs 0%, and 20.7% vs 77.8%, respectively; all P 〈 0.05）.CONCLUSION： The pathological features of biopsy specimens have limited value in differential diagnosis of Crohn＇s disease and intestinal tuberculosis. The pathological features of operative specimens have appreciable value in differentiating Crohn＇s disease from intestinal tuberculosis. It is essential to combine clinical, endoscopic and imageologic parameters to differentially diagnose the two diseases.
出处
《世界华人消化杂志》
CAS
北大核心
2010年第4期409-412,共4页
World Chinese Journal of Digestology
基金
湖南湘西自治州科技研发基金资助项目
No.2009015~~
关键词
克罗恩病
肠结核
活检标本
手术标本
病理学
Crohn＇s disease
Intestinal tuberculosis
Biopsy specimen
Operative specimen
Pathology
