FOXP3表达及病理组织学特征在溃疡性结肠炎诊断和鉴别诊断中的作用  

Role of combined FOXP3 expression and histological features in the diagnosis and differential diagnosis of ulcerative colitis

作　　者：汪稳庚 江燕[1,3] 何银环[2] 程平 窦红漫 胡乃中[4] 蔡永萍[1,3] WANG Wen-geng;JIANG Yan;HE Yin-huan;CHENG Ping;DOU Hong-man;HU Nai-zhong;CAI Yong-ping(Department of Pathology,School of Basic Medical Science,Anhui Medical University,Hefei 230032,China;Department of Pathology,the First Affiliated Hospital of Anhui University of Traditional Chinese Medicine,Hefei 230031,China;Department of Pathology,the First Affiliated Hospital of Anhui Medical University,Hefei 230022,China;Department of Gastroenterology,the First Affiliated Hospital of Anhui Medical University,Hefei 230022,China)

机构地区：[1]安徽医科大学基础医学院病理学教研室,合肥230032 [2]安徽中医药大学第一附属医院病理科,合肥230031 [3]安徽医科大学第一附属医院病理科,合肥230022 [4]安徽医科大学第一附属医院消化内科,合肥230022

出　　处：《临床与实验病理学杂志》2023年第7期807-810,共4页Chinese Journal of Clinical and Experimental Pathology

摘　　要：目的探讨FOXP3表达及病理组织学特征在溃疡性结肠炎(ulcerative colitis,UC)、感染性肠炎及孤立性直肠黏膜溃疡综合征(solitary rectal ulcer syndrome,SRUS)诊断和鉴别诊断中的作用。方法收集64例UC、24例感染性肠炎和14例SRUS。采用免疫组化EnVision两步法检测FOXP3在UC、感染性肠炎和SRUS淋巴细胞中的表达,计数10个高倍镜视野(high power field,HPF)下阳性淋巴细胞数目,取平均值;评估三组病变中4项病理组织学特征:黏膜腺体结构改变、固有层慢性炎细胞增多、黏膜基底部淋巴浆细胞增多和隐窝炎、隐窝脓肿。结果UC组中FOXP3阳性淋巴细胞数(52.60个/HPF)明显高于感染性肠炎组(11.30个/HPF)和SRUS组(9.30个/HPF),差异有统计学意义。组织学特征:与感染性肠炎组相比,UC组具有明显的黏膜腺体结构改变(UC组:61/64;感染性肠炎组:5/24)和黏膜基底部淋巴浆细胞增多(UC组:55/64;感染性肠炎组:5/24),而在固有层慢性炎细胞增多(UC组:64/64;感染性肠炎组:24/24)和隐窝炎、隐窝脓肿(UC组:36/64;感染性肠炎组:14/24)方面差异无统计学意义。与SRUS组相比,UC组具有明显的固有层慢性炎细胞增多(UC组:64/64;SRUS组:1/14)、黏膜基底部淋巴浆细胞增多(UC组:55/64;SRUS组:1/14)和隐窝炎、隐窝脓肿(UC组:36/64;SRUS组:1/14),而在黏膜腺体结构改变方面差异无统计学意义(UC组:61/64;SRUS组:14/14)。FOXP3阳性细胞数>23个/HPF(Cut-off值)时,联合组织学特征高度支持UC的诊断。结论联合FOXP3表达和组织学特点有助于UC的诊断及与感染性肠炎和SRUS的鉴别。Purpose To explore the role of combined FOXP3 immunohistochemical detection and histopathological features in the diagnosis and differential diagnosis of ulcerative colitis(UC),infectious enteritis and solitary rectal ulcer syndrome(SRUS).Methods Sixty-four cases of UC,24 cases of infectious enteritis and 14 cases of SRUS were diagnosed.Immunohistochemical EnVision two-step method was used to observe the expression of FOXP3 in lymphocytes of each group of cases,the number of positive lymphocytes in 10 high power field(HPF)were counted and averaged,and 4 histopathological features in each group of cases were observed and evaluated:structural changes of mucosal glands,increased chronic inflammatory cells in the lamina propria,increased mucosal basal plasma cells and cryptitis,crypt abscess.Results The number of FOXP3 positive cells in the UC group was significantly higher than that in the infectious enteritis group and the SRUS group,and the difference was statistically significant(52.60/HPF for UC vs 11.30/HPF for infectious enteritis vs 9.30/HPF for SRUS).Histopathologically,compared with the infectious enteritis group,the UC group had obvious changes in mucosal gland structure(61/64 for UC vs 5/24 for infectious enteritis)and increased mucosal basal plasma cells(55/64 for UC vs 5/24 for infectious enteritis),while in the lamina propria chronic inflammatory cells increased(64/64 for UC vs 24/24 for infectious enteritis)and cryptitis,crypt abscess(36/64 for UC vs 14/24 for infectious enteritis);There was no noticeable difference.Compared with the SRUS group,the UC group had significantly increased lamina propria chronic inflammatory cells(64/64 for UC vs 1/14 for SRUS),increased mucosal basal plasma cells(55/64 for UC vs 1/14 for SRUS)and cryptitis,crypt abscess(36/64 for UC vs 1/14 for SRUS),while there was no significant difference in mucosal gland structure changes(61/64 for UC group vs 14/14 for SRUS).The number of FOXP3 positive cells was greater than 23/HPF(Cut-off value),which highly supported the diagnosis

关 键 词：溃疡性结肠炎 感染性肠炎 孤立性直肠黏膜溃疡综合征 FOXP3 免疫组织化学 

分 类 号：R574.62[医药卫生—消化系统]