摘要
目的分析大肠侧向发育型肿瘤(LSTs)的内镜表现和病理特征,为术前充分评估肿瘤风险及选择治疗策略提供参考依据。方法回顾性分析2019年1月—2023年12月承德医学院附属医院内镜治疗的LSTs患者临床资料,分析病灶部位、大小、形态分型、组织学类型等方面临床和病理特征。结果共168个病例,病灶形态分型以颗粒型为主,占72.6%(122/168);病理类型以腺瘤为主,占78.6%(132/168)。组织学类型主要表现为低级别上皮内瘤变,占83.3%(140/168)。直径≥20 mm的LSTs多见于直肠,主要呈结节混合型,癌变率高于直径<20 mm的LSTs,分别为33.3%、46.3%和24.1%(P<0.05);而直径<20 mm的LSTs多见于升结肠,主要呈颗粒均一型,分别为45.0%和50.0%(P<0.05)。直肠LSTs病灶最大径中位数大于右半结肠及左半结肠,主要呈结节混合型,癌变率高于右半结肠及左半结肠,分别为[25(22,30)mm、67.5%和34.9%,P<0.05]。癌变组病灶最大径中位数大于低级别上皮内瘤变组,多见于直肠,主要呈结节混合型,分别为[25(22,30)mm、53.6%和67.9%,P<0.05];而低级别上皮内瘤变组病灶多见于升结肠,主要呈颗粒均一型,分别为37.1%和41.1%(P<0.05)。结论大肠LSTs临床及病理特征具有一定的特异性,直肠是直径≥20 mm且癌变的LSTs最常见的部位,其病灶形态以结节混合型为主,LSTs恶变潜能与病灶部位、直径及病灶形态有关。
Objective To analyze the endoscopic and pathological features of colorectal laterally spreading tumors(LSTs)and provide a referencefor fully evaluating therisk of tumor and selecting strategies before therapy.Methods The clinical data of patients with LSTs treated endoscopically in the Affiliated Hospital of Chengde Medical College from January 2019 to December 2023 were selected as retrospective study objects,and the clinical and pathological characteristics of lesion location,size,morphological typing,and histological type were analyzed.Results In total,168 patients were included,and 72.6%(122/168)were classified by granular type.Adenomas were the main pathological morphologies,accounting for 78.6%(132/168).The main histological type was low-grade intraepithelial neoplasia,accounting for 83.3%(140/168).LSTs with a diameter of≥20 mm were mainly found in the rectum,and mainly with granular-mixedmorphology,and the carcinogenesis rate was higher than that of LSTs with a diameter of<20 mm(33.3%,46.3% and 24.1%,respectively,P<0.05),while LSTs with a diameter of<20 mm were more common in the ascending colon,and were mainly with granular.The rectal LSTs had greater median maximum diameter compared to the right colon and the left colon,mainly with morphology granular-mixed,,and the carcinogenesis rate of the rectum was higher than that of the right colon and the left colon[25(22,30)mm,67.5% and 34.9%,respectively,P<0.05].In the cancerization group,the median maximum diameter of lesions was greater than that in the low-grade intraepithelial neoplasia group,most of lesions were located in the rectum,with the morphology granular-mixed[25(22,30)mm,53.6% and 67.9%,P<0.05].In the low-grade intraepithelial neoplasia group,most of lesions were mainly found in the ascending colon,with the morphology granular homogeneous(37.1%and 41.1%,respectively,P<0.05).Conclusion The clinical characteristics of colorectal LSTs have certain specificity.The rectum is the most common site of LSTs with a diameter of≥20 mm and cancerization of
作者
刘素英
孙玮螺
李萍
付强
刘飞
陈健
LIU Suying;SUN Weiluo;LI Ping;FU Qiang;LIU Fei;CHEN Jian(Department of Gastroenterology,Affiliated Hospital of Chengde Medical College,Chengde Hebei 067000,China)
出处
《中国急救复苏与灾害医学杂志》
2024年第9期1215-1218,1223,共5页
China Journal of Emergency Resuscitation and Disaster Medicine
基金
河北省医学科学研究课题计划项目(编号:20231365)
承德市科学技术研究与发展计划项目(编号:202006A080)。
关键词
大肠侧向发育型肿瘤
内镜特点
病理特征
Colorectal lateral spreading tumors
Endoscopic features
Pathological features
