显微镜结肠炎39例临床病理学分析
| 作者: |
1张桂芳,
2史传兵,
2杨晓俊,
2张发明
1 南京医科大学第二附属医院泗阳分院，泗阳县人民医院病理科，江苏 泗阳 223700 2 南京医科大学第二附属医院肠病中心，南京 210011 |
| 通讯: |
史传兵
Email: chuanbingshi78@126.com |
| DOI: | 10.3978/j.issn.2095-6959.2015.06.039 |
| 基金: | 国家自然科学基金, 81100253 南京医科大学科技发展基金重点项目, 2012NJMU084 |
摘要
目的：探讨显微镜结肠炎(microscopic colitis，MC)的临床病理学特点、诊断及鉴别诊断。方法：对39例MC的临床特点、组织形态学、免疫组织化学及Masson染色结果进行分析，并复习相关文献。结果：39例MC中男性18例，女性21例，年龄25~74岁，中位年龄50岁。所有患者均有慢性水样腹泻症状，结肠镜检查正常，其中淋巴细胞性结肠炎(lymphocytic colitis，LC)19例，胶原性结肠炎(collagenous colitis，CC)20例。显微镜下表层上皮细胞间淋巴细胞数(intraepithelial lymphocytes，IEL)为(21.5±8.6)，表层上皮下胶原带宽带为(14.3±4.0) µm，与对照组相比差异均有显著性(P<0.01)。结论：MC是老年患者慢性水样腹泻较常见的一种病因，诊断依赖于临床病史、结肠镜及病理组织学检查。
关键词：
显微镜结肠炎
淋巴细胞性结肠炎
胶原性结肠炎
Clinicopathologic study of microscopic colitis in 39 cases
CorrespondingAuthor: SHI Chuanbing Email: chuanbingshi78@126.com
DOI: 10.3978/j.issn.2095-6959.2015.06.039
Abstract
Objective: To determine the clinicopathologic features, immunohistochemistry, diagnosis and differential diagnosis of microscopic colitis (MC). Methods: Clinical characteristics, pathological morphology, immunohistochemical and Masson staining in 39 cases of MC were analyzed, and literature was reviewed. Results: The patients included 21 females and 18 males. The age of patients ranged from 25 to 74 years
(median =51 years). The results of colonoscopy in all patients with chronic watery diarrhea were normal. The number of lymphocytic colitis (LC) and collagenous colitis (CC) were 19 and 20 respectively. Microscopically, the number of intraepithelial lymphocytes (IEL) was 21.5±8.6, and the subepithelial collagen band was 14.3±4.0 µm , both were higher than the control group (P<0.01). Conclusion: MC is a common cause of chronic watery diarrhea. The diagnosis of MC depends on clinical history, colonoscopy and histologic characteristics.
(median =51 years). The results of colonoscopy in all patients with chronic watery diarrhea were normal. The number of lymphocytic colitis (LC) and collagenous colitis (CC) were 19 and 20 respectively. Microscopically, the number of intraepithelial lymphocytes (IEL) was 21.5±8.6, and the subepithelial collagen band was 14.3±4.0 µm , both were higher than the control group (P<0.01). Conclusion: MC is a common cause of chronic watery diarrhea. The diagnosis of MC depends on clinical history, colonoscopy and histologic characteristics.