摘要
目的 分析慢性HBV感染者并发结直肠息肉的内镜下特征及病理特征,探讨其癌变风险及内镜下治疗难度。方法 选择2019年1月至2022年12月在承德市中心医院接受内镜下息肉切除治疗的147例患者作为研究对象,将53例合并HBV感染的患者设为HBV组,将94例无HBV感染的患者设为对照组。收集患者的基本信息,以及入院血清癌胚抗原(CEA)检测、内镜和病理检查结果等资料。比较2组各肠段的息肉检出率、内镜下特征及病理特征、内镜下治疗时间、术中和术后出血率、血清CEA水平。结果 HBV组的直肠息肉检出率显著高于对照组(43.40%比25.53%,P=0.026)。HBV组的息肉最大径、息肉数目、息肉带蒂率、内镜下治疗时间、术中出血率和血清CEA水平均显著高于对照组(P均<0.05)。HBV组的腺瘤性和癌性息肉发生率显著高于对照组(92.45%比70.21%,P=0.002)。结论 与一般人群相比,慢性HBV感染并发结直肠息肉患者的直肠息肉检出率较高;病理检查结果多为腺瘤性或癌性息肉,息肉的癌变风险较高;息肉多数较大、带蒂且多发,术中出血率较高,内镜下治疗难度和并发症发生风险均较高,建议早期筛查。
Objective This paper intends to analyze the endoscopic and pathological characteristics of colorectal polyps in patients with chronic HBV infection,and explore their cancer risk and difficulty in endoscopic treatment.Methods A hundred and forty-seven patients who underwent endoscopic polypectomy at Chengde Central Hospital from January 2019 to December 2022 were selected as the study subjects.Fifty-three patients with HBV infection were assigned to the HBV group,and ninety-four patients without HBV infection were assigned to the control group.The basic information of the patient,as well as data on serum carcinoembryonic antigen(CEA)testing,endoscopic,and pathological examination results upon admission,were collected.The polyp detection rate,endoscopic and pathological characteristics,endoscopic treatment time,intraoperative and postoperative bleeding rates,and serum CEA levels of each intestinal segment in two groups were compared.Results The detection rate of rectal polyps in the HBV group is significantly higher than that in the control group(43.40%versus 25.53%,and P=0.026).The maximum diameter,number,pedicle rate,endoscopic treatment time,intraoperative bleeding rate,and serum CEA level of the HBV group are significantly higher than those of the control group(P<0.05).The incidence of adenomatous polyps and cancerous polyps in the HBV group is significantly higher than that in the control group(92.45%versus 70.21%,and P=0.002).Conclusions Compared with the general population, patients with chronic HBV infection complicated by colorectal polyps have a higher detectionrate of rectal polyps. The pathological examination results are mostly adenomatous polyps or cancerouspolyps, which have a higher risk of cancerous transformation. Polyps are often large, pedicled, and frequent,with a high intraoperative bleeding rate. Endoscopic treatment is difficult and the risk of complications ishigh. Early screening is recommended.
作者
郭天宇
花海洋
李建辉
王爱民
GUO Tianyu;HUA Haiyang;LI Jianhui;WANG Aimin(The Second Clinical College,Chengde Medical College,Chengde 067000,China;Department of Gastroenterology,Chengde Central Hospital,Chengde 067000,China)
出处
《国际消化病杂志》
CAS
2024年第3期171-174,195,共5页
International Journal of Digestive Diseases
