摘要
目的探讨结直肠侧向发育型肿瘤(laterally spreading tumor,LST)为锯齿状病变合并高级别上皮内瘤变(high-grade intraepithelial neoplasia,HGIN)或癌变的相关危险因素。方法回顾性分析2020年1月至2021年12月在新疆医科大学第一附属医院消化内镜中心经内镜诊断并行内镜下治疗或外科手术治疗的LST型锯齿状病变合并HGIN及癌变105例患者病历资料,分析病变病理性质与患者内镜下表现的相关性,并分析总结LST病变为锯齿状病变合并HGIN相关危险因素。结果共纳入105例LST型锯齿状病变患者,男61例,女44例,年龄(61.65±12.62)岁(14~88岁),病变直径(26.87±14.40)mm(10~80 mm)。发生HGIN者19例,发生黏膜下浸润癌者28例。HGIN及癌变部位以远端结肠为主,LST分型以结节混合型为主。单因素分析显示,患者年龄、服用阿司匹林、冠状动脉粥样硬化性心脏病史、慢性胆囊炎史、病变直径、内镜下分型、病变部位、病理分型是LST型锯齿状病变合并HGIN及癌变的相关危险因素(P<0.05)。多因素Logistic回归分析显示,结肠近端病变、病变大小≥20 mm、慢性胆囊炎史、冠状动脉粥样硬化性心脏病史、病理分型为SSL型是LST型锯齿状病变合并HGIN及癌变的独立危险因素。结论结肠近端病变、病变直径≥20 mm、慢性胆囊炎史、冠状动脉粥样硬化性心脏病史、病理类型为SSL型是LST型锯齿状病变合并HGIN及癌变的独立危险因素,内镜医师应综合评估患者病情,尽早行内镜下治疗或外科手术干预。
Objective To investigate risk factors of serrated colorectal in type of laterally spreading tumor(LST)combined with high-grade intraepithelial neoplasia(HGIN)or canceration.Methods A retrospective study was conducted on date of 105 patients with LST type serrated lesions complicated with HGIN or canceration diagnosed by endocardial endoscopy and treated by endoscopy or surgery in the First Affiliated Hospital of Xinjiang Medical University from Jan.2020 to Dec.2021.Analyzing the correlation between the pathological nature of the lesion and the patient′s basic information and endoscopic manifestations.And the relevant risk factors of LST typed serrated lesions with HGIN or canceration were analyzed and summarized.Results A total of 105 cases of LST typed serrated lesions were enrolled,including 61 males and 44 females,aged(61.65±12.62)years old.The lesion diameter was(26.87±14.40)mm(10-80 mm).There were 19 cases of HGIN,28 cases of submucosal invasive carcinoma.The HGIN or canceration was mainly located in the distal colon,and the LST classification was mainly nodal mixed type.In univariate analysis,age,taking Aspirin,coronary atherosclerotic heart history,chronic cholecystitis history,lesion diameter,endoscopic classification,lesion location and pathological classification were risk factors associated with LST typed serrated lesions with HGIN and canceration(all P<0.05).Multivariate Logistic regression analysis showed that proximal colon lesions,lesions diameter≥20 mm,chronic cholecystitis,history of coronary atherosclerotic heart disease,pathological type of SSL were independent risk factors for LST type serrated lesions with HGIN and canceration.Conclusion Proximal colon lesions,lesions diameter≥20 mm,chronic cholecystitis,history of coronary atherosclerotic heart disease,pathological type of SSL are independent risk factors for LST type serrated lesions with HGIN and canceration.Endoscopists should comprehensively evaluate the patient′s condition and perform endoscopic treatment or surgical intervent
作者
木合塔尔·色特瓦勒迪
古丽巴哈尔·司马义
MUHETAER·Setewaledi;GULIBAHAER·Simayi(The First Department of Gastroenterology,the First Affiliated Hospital of Xinjiang Medical University,Urumqi 830011,China)
出处
《胃肠病学和肝病学杂志》
CAS
2023年第9期1010-1014,共5页
Chinese Journal of Gastroenterology and Hepatology
关键词
结直肠侧向发育型肿瘤
锯齿状病变
高级别上皮内瘤变
癌变
Colorectal laterally spreading tumor
Serrated lesions
High grade intraepithelial neoplasia
Canceration
