溃疡Ulcer · 口腔黏膜 · 消化系统 · NTP ntp-0223
诊断要点:溃疡应当根据病变的范围和数量进行诊断和分级。与溃疡相关的炎症和上皮增生通常不单独诊断,除非它是病变的重要组成部分。
病变描述
与黏膜坏死一样,口腔内的黏膜溃疡(Figure 1、Figure 2、Figure 3、Figure 4)可能是与处理相关的作用,但更常见是由灌胃操作和/或异物(毛干、食物残渣)存在所致的创伤引起。溃疡区域可伴有慢性活动性炎症(Figure 3、Figure 4)和肉芽组织。然而,由于口腔上皮的增殖能力,轻微的创伤性病变通常在数日内愈合。啮齿类动物口腔内鳞状上皮的角化通常使其对外源性化学物质直接毒性的易感性低于人类口腔,后者主要衬以非角化上皮。
诊断与分级建议(NTP 共识)
溃疡应当根据病变的范围和数量进行诊断和分级。与溃疡相关的炎症和上皮增生通常不单独诊断,除非它是病变的重要组成部分。如果黏膜上皮细胞缺失但基底层仍存在并覆盖黏膜下层,则可诊断为糜烂(erosion)。当一部分上皮缺失或未附着于黏膜下层时,诊断为溃疡(ulcer)。如果上皮已坏死但仍存在并附着于黏膜下层,则诊断为坏死(necrosis)。
图谱


英文原文
展开 NTP 官方英文描述与建议
Comment:
As with mucosal necrosis, mucosal ulceration in the oral cavity ( Figure 1 , Figure 2 , Figure 3 , and Figure 4 ) can be a treatment-related effect but is more commonly caused by trauma due to the gavage procedure and/or the presence of foreign bodies (hair shafts, food material). Areas of ulceration can be accompanied by chronic active inflammation ( Figure 3 and Figure 4 ) and granulation tissue. However, because of the proliferative capacity of the oral epithelium, minor traumatic lesions are usually healed in a few days. Keratinization of the squamous epithelium in the rodent oral cavity generally makes it less susceptible to direct toxicity from xenobiotics than the human oral cavity, which is lined primarily by a nonkeratinizing epithelium.
Recommendation:
Ulcers should be diagnosed and graded based on the extent and number of lesions. Inflammation and epithelial hyperplasia associated with ulcers is usually not diagnosed separately unless it is a significant component of the lesion. If epithelial cells are missing from the mucosa but the basal layers are still present and covering the submucosa, then erosion may be diagnosed. Ulcers are diagnosed when a portion of the epithelium is absent or not attached to the submucosa. If the epithelium is necrotic but is still present and attached to the submucosa, then necrosis is diagnosed.
来源与引用
原始条目:https://ntp.niehs.nih.gov/atlas/nnl/alimentary-system/oral-mucosa/Ulcer
图谱总目录:NTP Nonneoplastic Lesion Atlas。 内容属美国联邦政府作品(公有领域),可引用;引用时请标注来源。
建议引用格式:NTP Nonneoplastic Lesion Atlas. Ulcer (oral-mucosa). LabSmart 中文版:
https://www.labsmart.cn/ntp/oral-mucosa-ulcer.html
中文图谱总页(可展开对照全部 595 条):https://www.labsmart.cn/ntp-atlas.html#oral-mucosa-ulcer