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1.
为了探讨帽状息肉病的临床、内镜特征,并评价其内镜下切除治疗效果,对2017年6月—2021年2月首都医科大学附属北京友谊医院行内镜黏膜下剥离术(endoscopic submucosal dissection,ESD)或内镜黏膜切除术(endoscopic mucosal resection,EMR)结直肠息肉切除治疗,经术后病理证实为帽状息肉病的14例病例(共56枚息肉)进行了回顾性分析。结果显示:男8例,女6例;年龄14岁~74岁,其中<60岁7例,≥60岁7例;7例(50.0%)伴消化道症状;息肉多发4例,单发10例(71.4%);息肉位于直肠42枚(75.0%),乙状结肠13枚(23.2%),横结肠1枚;山田分型Ⅰ型44枚(78.6%),Ⅱ型3枚,Ⅲ型5枚,Ⅳ型4枚;内镜下息肉表面可见明显白色帽状覆盖物41枚(73.2%)、明显充血发红23枚,其中两者均可见8枚;2例行ESD治疗、12例行EMR治疗,均完全切除,均未出现出血、穿孔、感染等并发症;7例伴消化道症状者术后临床症状均获得缓解;11例(78.6%)随访期间完成肠镜复查,均未见息肉复发。由此可见,帽状息肉病无性别、年龄发病差异,息肉多单发,直肠及乙状结肠多见,形态以山田Ⅰ型为主,表面多有白色帽状覆盖物,患者可无明显消化道症状,内镜下切除治疗安全、有效。 相似文献
2.
目的调查分析某地区胆囊息肉样病变(PLG)的自然病程及相关危险因素对其病程变化的影响。
方法统计西南医科大学附属医院2010年3月至2016年1月经超声诊断为PLG并在肝胆外科门诊长期随访的510例患者临床资料,分析PLG直径增长情况以及危险因素。
结果510例中单发息肉293例(57.5%),随访15(2~58)个月,300例(58.8%)息肉直径增大2(1~10)mm,年平均增长速度为0.4 mm;196例(38.4%)直径无变化;8例直径减小;6例消失。单因素分析及多因素Logistic回归分析显示,饮酒和睡眠质量差是PLG直径增大的危险因素(P<0.01),饮酒者的PLG直径增大的风险是非饮酒者的2.615倍,睡眠质量差者的息肉增大风险是睡眠质量正常者的2.282倍。
结论泸州地区PLG患者的增长速度缓慢,饮酒、睡眠质量差可能是促进胆囊息肉增长的危险因素。 相似文献
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Jacqueline LimaYolanda TeixeiraCélia PimentaAledson Vitor FelipeTiago Donizetti SilvaErmelindo Ermelindo Della Libera JuniorSarhan Sydney SaadElisabeth DeakHelena MurrayNora Manoukian Forones 《Asian Pacific journal of cancer prevention》2019,20(10):2929-2934
Background: Colorectal cancer (CRC) is one of the most frequent cancers. Genetic mutations in CRC already
described can be detected in feces. Microarray methods in feces can represent a new diagnostic tool for CRC and
significant improvement at public health. Aim: to analyze stool DNA by human DNA quantify and microarray
methods as alternatives to CRC screening. Method: Three methods were analyzed in stool samples: Human DNA
Quantify, RanplexCRC and KRAS/BRAF/PIK3CA (KBP) Arrays. Results: KBP array mutations were presented in
60.7% of CRC patients and RanplexCRC Array mutations in 61.1% of CRC patients. Sensitivity and specificity for
human DNA quantification was 66% and 82% respectively. Fecal KBP Array had 35% sensitivity and 96% specificity
and RanplexCRC Array method had 78% sensitivity and 100% specificity. Conclusion: Microarray methods showed
promise as potential biomarkers for CRC screening; however, these methods had to be optimized to improve accuracy
and applicability by clinical routine. 相似文献
5.
《Journal of pediatric urology》2021,17(6):855.e1-855.e4
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目的探讨口服造影剂胃超声检查在胃息肉诊断中的应用价值。 方法回顾性选取2016年1月至2019年12月于湖州市南浔区人民医院就诊、经口服造影剂胃超声检查诊断的胃息肉患者67例。所有患者均经胃镜和病理诊断确诊为胃息肉。对患者的超声表现、分型及诊断符合率等进行分析。 结果本组67例患者超声检查共发现胃息肉69个,息肉最大径5~34 mm,平均(15.6±4.8)mm。经病理诊断腺瘤性息肉34个、增生性息肉23个、炎性息肉9个、脂肪瘤1个、腺瘤恶变2个,超声诊断与胃镜和病理诊断符合率为95.65%(66/69)。胃息肉超声表现为起自黏膜层凸向胃腔的丘状、球状、乳头状、杆状及不规则形结构,边界多清晰;形态上无蒂28个(Ⅰ型12个、Ⅱ型16个),有蒂41个(Ⅲ型18个、Ⅳ型23个);肿块内回声表现为低回声58个、高回声10个、混合回声1个;彩色多普勒显示14个有内部血流信号。本组胃息肉分为肿瘤性(包括腺瘤性、脂肪瘤和恶变者)37个和非肿瘤性(包括增生性和炎性)32个,2组在息肉大小、回声分布均匀性、内部有无血流信号、基底有无蒂方面,差异均有统计学意义(P=0.009、0.036、0.036、0.000)。 结论胃息肉具有特征性的超声声像图表现,超声诊断符合率较高,体积较大、内部有血流信号、回声欠均匀的有蒂息肉需警惕存在恶变可能。口服造影剂胃超声检查方法便捷、患者依从性好,具有一定的临床应用价值。 相似文献
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Antonio Biondi Francesco Basile Marco Vacante 《World journal of gastrointestinal oncology》2021,13(6):495-508
Patients with familial adenomatous polyposis (FAP), an autosomal dominant hereditary colorectal cancer syndrome, have a lifetime risk of developing cancer of nearly 100%. Recent studies have pointed out that the gut microbiota could play a crucial role in the development of colorectal adenomas and the consequent progression to colorectal cancer. Some gut bacteria, such as Fusobacterium nucleatum, Escherichia coli, Clostridium difficile, Peptostreptococcus, and enterotoxigenic Bacteroides fragilis, could be implicated in colorectal carcinogenesis through different mechanisms, including the maintenance of a chronic inflammatory state, production of bioactive tumorigenic metabolites, and DNA damage. Studies using the adenomatous polyposis coliMin/+ mouse model, which resembles FAP in most respects, have shown that specific changes in the intestinal microbial community could influence a multistep progression, the intestinal “adenoma-carcinoma sequence”, which involves mucosal barrier injury, low-grade inflammation, activation of the Wnt pathway. Therefore, modulation of gut microbiota might represent a novel therapeutic target for patients with FAP. Administration of probiotics, prebiotics, antibiotics, and nonsteroidal anti-inflammatory drugs could potentially prevent the progression of the adenoma-carcinoma sequence in FAP. The aim of this review was to summarize the best available knowledge on the role of gut microbiota in colorectal carcinogenesis in patients with FAP. 相似文献
10.
Deepanshu Jain Mojdeh Momeni Mahesh Krishnaiah Sury Anand Shashideep Singhal 《World journal of gastroenterology : WJG》2015,21(13):3994-3999
AIM: To evaluate the impact of reporting bowel preparation using Boston Bowel Preparation Scale(BBPS) in clinical practice.METHODS: The study was a prospective observational cohort study which enrolled subjects reporting for screening colonoscopy. All subjects received a gallon of polyethylene glycol as bowel preparation regimen. After colonoscopy the endoscopists determined quality of bowel preparation using BBPS. Segmental scores were combined to calculate composite BBPS. Site and size of the polyps detected was recorded. Pathology reports were reviewed to determine advanced adenoma detection rates(AADR). Segmental AADR's were calculated and categorized based on the segmental BBPS to determine the differential impact of bowel prep on AADR. RESULTS: Three hundred and sixty subjects were enrolled in the study with a mean age of 59.2 years, 36.3% males and 63.8% females. Four subjects with incomplete colonoscopy due BBPS of 0 in any segment were excluded. Based on composite BBPS subjects were divided into 3 groups; Group-0(poor bowel prep, BBPS 0-3) n = 26(7.3%), Group-1(Suboptimal bowel prep, BBPS 4-6) n = 121(34%) and Group-2(Adequate bowel prep, BBPS 7-9) n = 209(58.7%). AADR showed a linear trend through Group-1 to 3; with an AADR of 3.8%, 14.8% and 16.7% respectively. Also seen was a linear increasing trend in segmental AADR with improvement in segmental BBPS. There was statistical significant difference between AADR among Group 0 and 2(3.8% vs 16.7%, P 0.05), Group 1 and 2(14.8% vs 16.7%, P 0.05) and Group 0 and 1(3.8% vs 14.8%, P 0.05). χ2 method was used to compute P value for determining statistical significance.CONCLUSION: Segmental AADRs correlate with segmental BBPS. It is thus valuable to report segmental BBPS in colonoscopy reports in clinical practice. 相似文献