RESUMO
La Enfermedad de Crohn y la colitis ulcerosa representan las dos principales expresiones clínicas de las enfermedades inflamatorias intestinales (Ell) crónicas. La epidemiología de las El! ha cambiado en el tiempo; una vez consideradas infrecuentes; ahora son un importante problema gastroenterológíco en los países en vías de desarrollo con cambios demográficos. La etiología de las EII es aún desconocidos, pero es indudable que este es complejo y multifactorial. Las EII poseen un importante componente genético, genes relacionados con la respuesta inmune innata han sido descritos en la patogénesis de estas enfermedades. Estudios sugieren claramente que el proceso patológico de las EII consiste en una respuesta inmune local alterada frente a antígenos bacterianos de la flora intestinal comensal. El diagnóstico de las Ell se basa en la existencia de un cuadro clínico compatible sumado a la presencia de alteraciones endoscópica, histológicas y radiológicas características y no sobre la base de un único marcador de enfermedad.
Crohn 's disease and ulcerative colitis represent the two main forms of chronic inflammatory bowel diseases (IBD). The epidemiology of IBO has changed face over time; once considered rare, it is now a major gastroenterologic problem in the developed world with changing demographics. The origin of ISD remains unknown, but it is undoubted/y complex and multifactorial. The ISO have an important genetic background, genes related to the innate immune response have been observed to be involved in the pathogenesis of these diseases. Studies clearly suggest that the pathologic process in IBO consists of a dysregulated host immune response directed against bacterial antigens of the normal intestinal flora. The diagnosis of IBO is based on the composite clinical picture and endoscopic, histologic and radiologic characteristic and not on the basis of a single disease marker.
Assuntos
Humanos , Colite Ulcerativa/diagnóstico , Colite Ulcerativa/patologia , Doença de Crohn/diagnóstico , Doença de Crohn/patologia , Colite Ulcerativa/classificação , Colite Ulcerativa/epidemiologia , Diagnóstico Diferencial , Doença de Crohn/classificação , Doença de Crohn/epidemiologia , Prognóstico , Índice de Gravidade de DoençaRESUMO
Ulcerative colitis [UC] is a relapsing and remitting disease characterized by acute non-infectious inflammation and shallow ulceration with increased risk of carcinoma in long standing cases. This study was designed for application of new grading activity system. and assessement of Ki67 and P53 alterations in UC cases complicated with dysplasia. This study was performed on 99 colorectal endoscopic biopsy specimens. Sections stained with Haematoxyline and eosin were examined for the diagnostic criteria of UC. Immunohistochemistery staining for p53 and Ki67 done only for the dysplastic cases. The following lesions were diagnosed in the 99 collected cases:11 cases show chronic nonspecific colitis without fulfilling the criteria of diagnosis of ulcerative colitis.88 cases were diagnosed as ulcerative colitis and its related dysplasia, they include: 63 cases UC with no associated dyspiasia, 25 cases UC with dysplasia divided into: a] 12 cases as indefinite for dysplasia. b] 6 cases with low grade dysplasia, c] 3 cases with high grade dysplasia, and d] 4 cases lost during immunohistochemical preparation. UC grading system of activity should be applied in UC cases to evaluate the present activity and so the treatment, UC cases with dysplasia must have routine immunohistochemistery staining of both P53 and Ki67 to evaluate the type of dyspiasia especially indefinite for dyspiasia. Low grade dyspiasia show positive staining for both P53 and Ki 67 in lower two thirds of crypt epithelium, while high grade dyspiasia show positive staining for both P53 and Ki 67 in the whole crypt epithelium
Assuntos
Humanos , Masculino , Feminino , Imuno-Histoquímica , Proteína Supressora de Tumor p53 , Antígeno Ki-67 , Biópsia , Colite Ulcerativa/classificação , Progressão da DoençaRESUMO
La colitis ulcerativa es una enfermedad inflamatoria crónica de etilogía desconocida, que afecta la mucosa del recto y una variable longitud del colon. No hay curación médica para esta enfermedad, sin embargo la terapia médica ofrece confort a la mayoría de pacientes y mejora sus vidas. La terapia médica incluyendo nuevas drogas se revisan en el presente artículo