ABSTRACT
Objective To investigate the pathohistologic features and grading of biopsy mucosae and their correlation with disease severity of active ulcerative colitis(UC). Methods A prospective study was conducted in 133 patients with UC who were divided into three groups based on the degree of severity. Pathologic morphometry and grading with HE staining sections were analyzed. Results Pathologic features of active UC: there were neutrophilic leukocytes (100.0%), eosinophils (99.2%), plasmacytes(91.7%) and lymphocytes (75.2%) infiltration among mucosal epithelial cells, and lymphoid follicular formation(72.2%) and small vessels inflammation(63.9%) and focal hemorrhage(68.4%) in lamina propria. There were crypt abscesses(43.6%), glandular abnormalities (44.4%), goblet cell depletion (18.8%), epithelial cell regeneration (36.8%) , atypical hyperplasia (28.6%) and granulation tissue formation (42.9%) in mucosae. With the increase of severity of UC, there was a significant increasing incidence of small vessel inflammation, fiberoid necrosis of vessel wall, glandular abnormality, epithelial cell regeneration, atypical hyperplasia, goblet cell depletion, granulation tissue formation, fiber tissue hyperplasia, and crypt abscess. There was no significant difference of the incidence of lymphocyte hyperplasia, lymphoid follicular formation, eosinophil and plasmacyte infiltration between the groups. Mild UC was mainly characterized by the lesions of Grade Ⅰ and Ⅱ, moderate UC by those of Grade Ⅱ and Ⅲ and severe UC by those of Grade Ⅲ and Ⅳ. There were significant differences of grades among mild, moderate and severe UC. Conclusions There were some pathologic characters in active UC. The partial of markers and histological gradings can reflect the severity and activity of active UC.
ABSTRACT
Objective To investigate the correlations between histological grading of the mucosal biopsies, clinical appearances and endoscopies of patients with active ulcerative colitis ( AUC) , and their roles in the therapeutic outcomes. Methods To analyze the grading in pathological, endoscopic and clinical manifestations of 133 patients, and use the scores to estimate each clinical appearance. A prospective study and Spearman correlation coefficients analysis were taken in this study. Results Among 133 patients, the grading of histological, clinical and endoscopic results in grades Ⅰ ,Ⅱ , Ⅲ , andⅣwere 29,45 ,37 and 22; 85 , 39,9 and 0; 8,30,16 and 79 cases respectively. There were significant positive correlations between histological grading and the following parameters; melena ( r =0. 49, P= 0. 000) , bowel movement ( r =0. 30, P = 0.001) , ESR (r=0. 42, P =0.000) , AI(r=0.56, P=0.000) , clinical grade (r=0.52, P=0.000) endoscopic grade (r = 0. 35 , P =0. 000). And no significant negative correlation with Hb (r = -0. 13, P = 0. 125). In 68 mild and moderate cases after administered SASP for 6 weeks with clinical remission there were 16 and 19 cases with 0 grade in endoscopies and histology respectively, and in the former group 7 cases fall in histological grade I . Conclusion There was no agreement in the clinical, endoscopic and histological grades of the AUC patients. For the evaluation of therapy, the sequence of priority is histological grade, endoscopic grade, and then clinical grade.