title: Subepithelial apoptosis in normal caecal biopsy specimens is primarily an age-related phenomenon.
abstract: OBJECTIVE
  To determine whether prominent subepithelial apoptosis in otherwise normal caecal endoscopic biopsy specimens has any clinical significance.
  
  
  RESULTS
  Calculating the average number of subepithelial apoptotic bodies per intercrypt space [i.e. a subepithelial apoptotic index (SAI)] was found to reflect accurately and reproducibly the density of subepithelial apoptosis in a colonic biopsy specimen. The SAIs of 124 histologically normal caecal biopsy specimens from adult patients showed a positively skewed normal distribution without bimodality. The clinical details of patients with specimens in the top quartile of this distribution were compared with those of patients in the bottom quartile. Patients in the top quartile were found to be older and more likely to suffer with ulcerative colitis than those in the bottom quartile. However, controlling for age removed the association between SAI and ulcerative colitis. The SAIs of 144 caecal biopsy specimens (including 20 paediatric cases) showed a positive correlation with patient age.
  
  
  CONCLUSIONS
  Subepithelial apoptosis in normal caecal biopsy specimens appears to be an age-related phenomenon with no demonstrable clinical significance.
authors.affiliation: Department of Histopathology, Bristol Royal Infirmary, Bristol, UK. nacs.wong@bristol.ac.uk
authors.forename: N A C S
authors.initials: NA
authors.lastname: Wong
authors.forename: R
authors.initials: R
authors.lastname: Jenkins
authors.forename: G J
authors.initials: GJ
authors.lastname: Reid
mesh_terms: D000367:Age Factors; D017209:Apoptosis; D001706:Biopsy; D002432:Cecum / Q000473:pathology*; D002648:Child; D003092:Colitis / Q000473:pathology; D003108:Colonic Diseases / Q000473:pathology; D004847:Epithelial Cells / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012007:Rectum / Q000473:pathology