Modern morphological diagnostics of ulcerative colitis and irritable bowel syndrome: histological, histochemical and immunohistochemical criteria

Abstract

The aim is to establish diagnostic and differential-diagnostic criteria for UC and IBS based on a complex morphological (histological, histochemical, immunohistochemical) study. Materials and methods: In this study, it was used autopsy and biopsy material – fragments of the mucous membrane of the large intestine. The material was divided into 5 groups. The first group (G 1) included autopsy material from 6 cases, in which, during autopsies and microscopic examination, we found no general pathological processes in the gastrointestinal tract. The second group (G 2) included biopsy material from 34 patients with diagnosed UC of the 1st activity degree. The third group (G 3) included the biopsy material of 27 patients with UC of the 2nd degree of activity. The fourth group (G 4) included biopsy material from 19 patients, diagnosed with UC of the 3rddegrees of activity. The fifth group (G 5) included biopsy material from 82 patients with clinically diagnosed IBS. Histological, histochemical, immunohistochemical, statistical research methods were used. Results: There are characteristic morphological changes in the mucous membrane of the large intestine in UC of varying degrees of activity, such as changes in the architectonics of crypts of varying severity; presence of erosive and ulcerative defects. Inflammatory and desquamative-dystrophic changes take place in the epithelial layer adjacent to erosive and ulcerative defects. The number of goblet cells of crypts decreases and the size of vacuoles in goblet cells reduces. The intensity of mucin secretion contained in the vacuoles of the goblet cells lowers; there is a partial or complete loss of pericryptal myofibroblasts; the proliferative potential of the intestinal crypts epithelium activates. Conclusions: Differential diagnostic criteria, revealed by the author, improve the morphological diagnosis of UC and IBS, optimizing the tactics of managing patients with this colorectal pathology.