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자료유형
학술저널
저자정보
Guduru Venkat Rao (Asian Institute of Gastroenterology Hyderabad India) Partha Pal (Asian Institute of Gastroenterology) Anuradha Sekaran (Asian Institute of Gastroenterology) Pradeep Rebala (Asian Institute of Gastroenterology) Manu Tandan (Asian Institute of Gastroenterology) D. Nageshwar Reddy (Asian Institute of Gastroenterology)
저널정보
대한장연구학회 Intestinal research Intestinal research Vol.21 No.2
발행연도
2023.4
수록면
196 - 204 (9page)
DOI
10.5217/ir.2022.00045

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After oncologic resection, histological grading and staging of the tumor give important prognostic information about the future risk of recurrence and hence influence the subsequent management plan. Several studies and their meta-analysis have shown that various histological features (e.g., microscopic positive resection margins, plexitis, granuloma, mesenteric inflammatory activity) can predict postoperative clinical/endoscopic/surgical recurrence after resection in Crohn’s disease (CD). Inclusion of mesentery in surgical resection specimens has been shown to reduce surgical recurrence after ileocolonic resection in CD. However, there is no uniform histopathological staging system for risk stratification in postoperative CD to systematically predict postoperative recurrence. This is because the prediction to date is based on clinical characteristics (smoking status, disease phenotype, surgical history). Histopathological predictors are still not adopted in routine clinical practice due to the lack of a uniform staging system, heterogeneity of published studies and lack of standardized definition of histological features. In this article, we attempted to incorporate all such histological features in a single histological staging system CNM (Crohn’s primary site [resection margin positivity, plexitis, granuloma, depth of infiltration], nodes [presence of granuloma], mesentery [involved or not]) in surgical resection specimen in CD. The proposed CNM classification would help to enable systematic reporting, design future clinical trials, stratify postoperative recurrence risk and choose appropriate postoperative prophylaxis.

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