摘要
目的:探讨大肠息肉的内镜、病理学特征,并分析癌变的相关因素.方法:将我院治疗的406例大肠息肉患者作为研究对象,分析大肠息肉发生的年龄、大小、形态、部位、病理类型以及癌变的相关因素.结果:老年组发生大肠息肉的比例最高,青年组大肠息肉发生率最低.大肠息肉发生部位均以乙状结肠、直肠最为常见,而回盲部息肉的发生几率较小.息肉直径≤1 cm比例最高,其中大部分为增生性息肉;息肉直径1-2 cm中腺瘤性比例最高,而直径>2 cm中幼年性息肉发生比例最高.无分叶组大肠息肉发生率较高,其中分叶组以腺瘤性发生率最高,无分叶组以增生性为主.老年组发生癌变率显著高于青年组和中年组(2=10.317,P<0.05);回盲部、直肠、乙状结肠等部位癌变率显著高于其他部位(2=5.787,P<0.05);随着息肉直径增大,癌变发生率越高;腺瘤性癌变率明显高于其他病理类型(2=67.183,P<0.05);而分叶状腺瘤的癌变率高于无分叶腺瘤.结论:临床上对大肠息肉患者镜检时应该尽可能检查全大肠,仔细观察息肉的形态、大小、部位,并进行病理活检;如果条件允许,应该摘除息肉,避免发生大肠癌变.
AIM： To sttmmarize the endoscopic and pathologi- cal characteristics of colorectal polyps and to ana- lyze risk factors for their malignant transformation. METHODS： A total of 406 patients with colorec- tal polyps treated at our hospital were included in this study. The endoscopic and pathological characteristics of colorectal polyps （including age, size, shape, location, and pathological type） were explored and risk factors for their malig- nant transformation were analyzed. RESULTS： The elderly group was associated with the highest incidence of colorectal polyps, followed by the middle-aged group and young group. Colorectal polyps were most commonly seen in the sigmoid colon and rectum, and ileo- cecal polyps were relatively rarely seen. Polyps with a diameter ≤ 1 cm were most commonly seen, and most of them were hyperplastic polyps. Polyps with a diameter of 1-2 cm were mostly adenomas. Polyps with a diameter 〉 2 cm were mostly juvenile polyps. Non-lobulated colorectal polyps were more commonly seen. Lobulated polyps were mostly adenomatous, while non- lobulated ones were mostly proliferative. The rate of malignant transformation was significantly higher in the elderly group than in the young and middle-aged groups （2 __ 10.317, P 〈 0.05）. Malig- nant transformation was more commonly seen in the ileocecal junction, rectum, sigmoid colon than in other locations （2 = 5.787, P 〈 0.05）. With the increase in polyp diameter, the probability of ma- lignant transformation increased. The probability of malignant transformation was more commonly seen in adenomas than in other pathologic types （X2 = 67.183, P 〈 0.05）, and in lobulated adenomas than in non-lobulated ones. CONCLUSION： Patients with colorectal pol- yps should undergo endoscopy to examine the whole colon to carefully observe the shape, size, site of polyps and conduct a biopsy. If possible, polyps should be removed to avoid the occur- rence of malignant transformation.
出处
《世界华人消化杂志》
CAS
北大核心
2013年第27期2886-2889,共4页
World Chinese Journal of Digestology
关键词
大肠息肉
癌变
内镜
病理
Colorectal polyps
Malignant transfor-mation
Endoscopy
Pathology
