ANALYSIS OF THE HISTOLOGIC VARIATION OF SYNOVITIS IN RHEUMATOID-ARTHRITIS
ANALYSIS OF THE HISTOLOGIC VARIATION OF SYNOVITIS IN RHEUMATOID-ARTHRITIS
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DOI：
10.1002/art.1780310803
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发表时间：
1988-08-01
影响因子：
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通讯作者：
BRESNIHAN, B
中科院分区：
文献类型：
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作者：
ROONEY, M;CONDELL, D;BRESNIHAN, B
对29例类风湿性关节炎患者的30个膝关节进行了滑膜活检，共获得滑膜活检标本145例。所有患者都有临床活动的类风湿性关节炎，没有人接受过慢效疾病修改药物或关节内皮质类固醇的治疗。对每个活检标本的6个组织学特征进行评分，以量化每个关节内的差异。在大多数膝关节活检中，所有组织学特征的评分都有相当大的聚集性。因此，在0-10的范围内，82%的滑膜细胞增生评分在给定关节的中位数1分以内。同样，其余特征(纤维化、血管增殖、血管周围浸润物、局灶性聚集物和淋巴细胞弥漫性浸润物)的得分在中位数1分以内的比例在69%到85%之间。8例患者在关节镜下进行了多次活检。从明显受累最大和受累最小的区域中选择组织，以增加区域组织学变异的可能性。在滑膜细胞增生评分中，91%的关节位于中位数1分以内，其余5个特征的评分中，72-94%的关节滑膜细胞增生评分在中位数1分以内。此外，滑膜衬里层增生、血管增殖、单核细胞浸润、纤维化程度与滑膜炎的临床指标之间也存在高度显著的统计学相关性。
One hundred forty-five synovial biopsy specimens were obtained from 30 procedures performed on the knee joints of 29 patients with rheumatoid arthritis. All patients had clinically active rheumatoid arthritis and none had received slow-acting disease-modifying drugs or intraarticular corticosteroids. Scores were assigned to each biopsy specimen for each of 6 histologic features to quantify variation within each joint. In the majority of knee joint biopsies, there was considerable clustering of scores for all histologic features. Thus, on a scale of 0-10, 82% of the scores for synoviocyte hyperplasia were within 1 point of the median score for a given joint. Similarly, between 69% and 85% of the scores for the remaining features (fibrosis, vessel proliferation, perivascular infiltrates, focal aggregates, and diffuse infiltrates of lymphocytes) were within 1 point of the median values. Multiple biopsies were obtained at arthroscopy in 8 patients. Tissue was selected from areas of apparent maximal and minimal involvement, to enhance the likelihood of regional histologic variation. Of the scores for synoviocyte hyperplasia, 91% were within 1 point of the median values for a given joint, and of the scores for the remaining 5 features, 72-94% fell within 1 point of the median values. In addition, highly significant statistical correlations of the intensity of synovial lining layer hyperplasia, vessel proliferation, mononuclear cell infiltration, fibrosis, and clinical measurements of synovitis were observed.