colonic mucosa with minimal crypt irregularity

This view is validated by recent findings showing that p53 over expression (a biomarker of epithelialcarcinogenesis) significantly correlated with architectural distortions of the crypts in UC. Based on these findings it is suggested that the microscopic search for HGD in UC colectomy-specimens should preferentially be focused to mucosal areas exhibiting CAD. Hence, out of the 203 crypts exhibiting HGD, 186 (91.6%) were CAD and the remaining 17 (8.4%) CNS (P< 0.05). In contrast, out of the 902 CAD present in the specimens, 343 (38.0%) displayed ISCC, 186 (20.6%) HGD, and the remaining 373 (41.4%) normal epithelium. Most mucosal areas, however, portrayed countless crypts with normal shapes (CNS) lined with normal epithelium, excepting 45 CNS: 28 showed in conclusive-suspected cellular changes (ISCC), and 17, HGD. No apparent differences in frequency between groups were found in colectomies with HGD/carcinoma, or in colectomies preformed for medically-refractory UC without HGD/carcinoma. The most frequent CAD group hadaxial polarity distortions (33.4%), and the less frequent CAD group, outline distortions (21.1%) (P< 0.05). CADs were subdivided into four groups: i) Crypts with fission distortions, ii) Crypts with length distortions, iii) Crypts with outlines distortions and iv) Crypts with axial polarity distortions. Five-hundred and sixteen histologic sections from 29 colectomy specimens with UC (24 having adenocarcinoma and five, high-grade dysplasia, HGD) were reviewed. Here we classify the histologic repertoireand assess the frequency of CAD in UC. In ulcerative colitis (UC) the colonic mucosa shows in addition to high number of inflammatory cells, crypts with architectural distortions (CAD).

Colonic mucosa with minimal crypt irregularity