炎症性肠病相关异型增生病理诊断问题与建议  

Recommendations on pathological diagnosis of inflammatory bowel disease associated dysplasia

作　　者：中华医学会消化病学分会炎症性肠病学组病理分组 肖书渊 叶子茵[3] Pathology Section,Inflammatory Bowel Disease Group,Chinese Society of Gastroenterology,Chinese Medical Association;Xiao Shuyuan(不详;Department of Pathology,University of Chicago,Chicago,Illinois 60637f USA)

机构地区：[1]不详 [2]芝加哥大学病理学系,美国伊利诺伊州芝加哥60637 [3]中山大学附属第一医院病理科

出　　处：《中华消化杂志》2022年第4期217-223,共7页Chinese Journal of Digestion

摘　　要：炎症性肠病(IBD)相关异型增生的早期发现和处理是降低IBD相关结直肠癌发生率的关键因素。IBD相关异型增生的病理诊断对临床决策至关重要,但医师诊断异型增生的主观性常较强,不同病理医师之间诊断一致性并不理想。为提高病理医师对IBD相关异型增生诊断的准确性,中华医学会消化病学分会炎症性肠病学组病理分组组织专家进行IBD相关异型增生病理诊断的测试和讨论,测试结果表明专题讲座和共同讨论有助于提高异型增生的诊断正确率,在组织形态学检查基础上联合免疫组织化学检查有助于异型增生的诊断。建议在诊断IBD相关异型增生时,由2位及以上病理医师独立阅片,意见一致方能作出诊断。Surveillance and early management of dysplasia in inflammatory bowel disease(IBD)play a key role in reducing incidence of IBD associated colorectal cancer.Confirmation of pathologic diagnosis of IBD associated dysplasia is important before management decisions.However,due to subjectivity in histologic diagnosis of dysplasia,interobserver agreement was only fair or moderate even among expert pathologists.In order to improve diagnostic agreement of IBD associated dysplasia,an expert group of Pathology Section,Inflammatory Bowel Disease Group,Chinese Society of Gastroenterology,Chinese Medical Association discussed relevant diagnostic issues and reached consensus.Although diagnosis of dysplasia is mainly based on routine histopathology,immunohistochemical staining may help in some challenge cases.It is strongly recommended that a second examination of the biopsies should be performed by an independent expert pathologist before a diagnosis of IBD associated dysplasia is made.

关 键 词：炎性肠疾病 克罗恩病 结肠炎 溃疡性 专家共识 临床指南 病理 异型增生 

分 类 号：R574[医药卫生—消化系统]