Affiliation:
1. North-Western State Medical University named after I.I.Mechnicov
2. National Center for Clinical Morphological Diagnostics
3. Avtsyn Research Institute of Human Morphology of Petrovsky National Research Centre of Surgery
Abstract
BACKGROUND. The steadyincrease in the number of inflammatoryboweldiseases(IBD)and the lack of reliablysignificantdiagnosticcriteriarequire the search for newmorphologicaldifferentialdiagnosticcriteria.
AIM. The aim of the studywas to determine the cellular-differentialcomposition of the intestinalepitheliuminvariousphasesofCrohn's disease andulcerativecolitis.
MATERIALS AND METHODS. The tissue material of 60 cases of IBD (Crohn's disease - 30 cases, ulcerative colitis - 30 cases) and 15 cases with irritable bowel syndrome, which was a comparison group, were studied. Histological, immunohistochemical, morphometric and statistical research methods were used.
As a result, the features of the cell-differential composition of the epithelium of the mucous membrane of the iliac, ascending, sigmoid, rectum were determined in all these nosologies, and in IBD during periods of exacerbation and remission. It was found that the proportion of goblet cells in the epithelial lining varies depending on the intestinal region, nosology and phase of the disease. Goblet cell differentiation: 25% more goblet cells of the intercriptal space of the ileum in acute Crohn's disease compared with remission (p=0,0002), 42,9% more goblet cells in the superficial epithelium of the ascending colon compared with IBS (p=0,0001), 23% more goblet cells crypts in sigmoid colon compared with acute stage UC (p=0,0024). There were no statistically significant differences in the differentiation of Paneth cells. Enteroendocrinocyte differon: 3 times more endocrinocytes in the sigmoid colon in acute Crohn's disease compared with IBS (p=0,0238). Nonepithelial differon cells: fewer interepithelial lymphocytes in CD in remission compared with CD in the acute stage by 2,4 times in the sigmoid colon, 4 times in the rectum (p0.0001); compared with IBS by 4,8 times in the ileum, 2,7 times in the ascending intestine, 4 times in the sigmoid colon (p0,05); 8 times in the rectum compared with UC in remission (p=0.0004). An increase in the proliferative activity of crypt cells (mainly goblet-shaped) by 4,2 times in the sigmoid colon in acute Crohn's disease compared with ulcerative colitis in the acute stage (p=0,0016) was found.
CONCLUSION. When determining the cellular-differential composition of the intestinal epithelium, morphometric parameters were established that can be used as differential diagnostic criteria for IBD.