克罗恩病肉芽肿检出率的影响因素回顾性分析

IF 2.9 4区医学 Q2 PATHOLOGY

Pathology, research and practice Pub Date : 2025-05-30 DOI:10.1016/j.prp.2025.156054

Yinxian Shen , Jun Wang , Haoying Liu , Shangzhan Huang , TingTing Qin , Xuantao Ji , Jiayuan Huang , Qi Zhou , Jiazhi Liao , Fang Xiao

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引用次数: 0

摘要

背景：组织病理学分析中非干酪化肉芽肿的检测是诊断克罗恩病（CD）的关键标准。肉芽肿的低频率识别给早期和准确诊断带来了重大挑战。本研究旨在确定影响CD患者肉芽肿检出率的因素，评估内镜下病变严重程度和病变类型对肉芽肿检出率的影响，最终提高活检准确性和非干酪化肉芽肿检出率。方法对308例肉芽肿阳性CD患者进行回顾性分析。收集年龄、性别、蒙特利尔分类、内镜检查结果、改良SES-CD评分和组织病理学。使用卡方检验评估肉芽肿检测（阳性与阴性）与肠段、标本数量和大小之间的关系。内镜下图像按改良的SES-CD标准分级。ResultsGranuloma检测标本中明显高于≥0.1  厘米相比& lt; 0.1 厘米(0.001 p & lt; )和增加样本数量,达到68.13 % N ≥ 5 (p & lt; 0.001)。回肠末、左结肠、右结肠的检出率明显高于直肠（p <； 0.005）。内镜下轻至中度组检出率高于重度组（p <； 0.016）和正常组（p = 0.001）。溃疡性病变的检出率明显高于非溃疡性病变（p = 0.001）。结论肉芽肿检出率与肠段、标本大小、数量、病变严重程度及形态有关。从轻度至中度病变区域进行活检可提高肉芽肿的检测。

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Influencing factors on detection rate of granuloma in Crohn's disease: A retrospective analysis

Background

The detection of non-caseating granulomas in histopathological analysis is a key criterion for Crohn’s disease (CD) diagnosis. The low frequency of granuloma identification poses a significant challenge to early and accurate diagnosis. This study aims to identify factors affecting granuloma detection rate in CD patients, as well as assess how endoscopic severity and lesion types influence detection, ultimately improving biopsy accuracy and non-caseating granuloma detection rate.

Methods

A retrospective analysis of 308 granuloma-positive CD patients was performed. Age, sex, Montreal classification, endoscopic findings, modified SES-CD scores, and histopathology were collected. Associations between granuloma detection (positive vs. negative) and bowel segment, specimen quantity, and size were evaluated using Chi-square tests. Endoscopic images were graded by modified SES-CD criteria.

Results

Granuloma detection was significantly higher in specimens ≥ 0.1 cm compared to < 0.1 cm (p < 0.001) and increased with specimen quantity, reaching 68.13 % at N ≥ 5 (p < 0.001). The terminal ileum, left colon, and right colon had significantly higher detection rates than the rectum (p < 0.005). Detection rates were higher in the endoscopic mild-to-moderate group than the severe group (p < 0.016) and the normal group (p = 0.001). Ulcerative lesions had significantly higher detection than non-ulcerative lesions (p = 0.001).

Conclusions

The granuloma detection rate correlates with bowel segment, specimen size and quantity, lesion severity, and morphology. Biopsying from regions of mild-to-moderate lesions may enhance granuloma detection.

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来源期刊

Pathology, research and practice 医学-病理学

CiteScore

5.00

自引率

3.60%

发文量

405

审稿时长

24 days

期刊介绍： Pathology, Research and Practice provides accessible coverage of the most recent developments across the entire field of pathology: Reviews focus on recent progress in pathology, while Comments look at interesting current problems and at hypotheses for future developments in pathology. Original Papers present novel findings on all aspects of general, anatomic and molecular pathology. Rapid Communications inform readers on preliminary findings that may be relevant for further studies and need to be communicated quickly. Teaching Cases look at new aspects or special diagnostic problems of diseases and at case reports relevant for the pathologist''s practice.