| 191例小于2 cm早期结直肠癌临床内镜特征分析 |
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| 引用本文： | 王亚丹,郭春梅,宿慧,刘揆亮,魏南,蔺武,刘红,王沧海,吴静. 191例小于2 cm早期结直肠癌临床内镜特征分析[J]. 中国肿瘤临床, 2018, 45(20): 1057-1061. DOI: 10.3969/j.issn.1000-8179.2018.20.697 |
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| 作者姓名： | 王亚丹 郭春梅 宿慧 刘揆亮 魏南 蔺武 刘红 王沧海 吴静 |
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| 作者单位： | 首都医科大学附属北京世纪坛医院消化内科(北京市100038) |
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| 摘 要： | 目的 分析较小病变(大小≤2 cm)早期结直肠癌临床内镜特征，以期指导内镜医师诊断较小早期结直肠癌，协助选择治疗方法。 方法 回顾性分析首都医科大学附属北京世纪坛医院2014年1月至2017年12月收治的191例(201例早期结直肠癌病变)早期结直肠癌患者(病变大小≤2 cm)资料，分别对早期结直肠癌的临床特点、内镜特征、病理特征进行回顾性分析。 结果 早期结直肠癌发病率男性高于女性(1.81:1)，以左半结肠为主(141/201)， < 1 cm早期结直肠癌形态学以Ⅱa型为主(20/67，P=0.037)、1~2 cm早期结直肠癌形态学以Ip型为主(52/134，P < 0.01)。 结论 早期结直肠癌在结直肠分布和内镜下表现存在一定的特征，虽然高危腺瘤定义是病变>1 cm，但本研究纳入191例早期结直肠癌患者，其中67例 < 1 cm。因此不论病变大小，如果内镜下观察到以下特征:分叶状、基底棘皮征、充血糜烂、病变饱满、表面凹陷等，均应警惕结直肠病变癌变可能，均应进一步详细评估。
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| 关 键 词： | 早期结直肠癌 病变分布 内镜特征 |
| 收稿时间： | 2018-07-05 |
Endoscopic features of early colorectal carcinomas smaller than 2cm: a retrospective study of 191 cases |
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| Affiliation: | Department of Gastroenterology, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China |
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| Abstract: | Objective To examine endoscopic features of early colorectal carcinomas smaller than 2 cm. Methods A total of 191 patients (201 early colorectal carcinomas) who were definitely diagnosed with early colorectal cancer smaller than 2 cm between January 2014 and December 2017 in Beijing Shijitan Hospital, Capital Medical University were enrolled. The patients' clinical characteristics, endoscopic and pathological data were retrospectively analyzed. Results There were more male patients than female patients(1.81:1) in the study population; distribution of lesions was higher in the left colon than in the right colon (141/201). Group 1 had ahigher number of Ⅱa lesions (20/67, P=0.037) and a lower number of Ip lesions than Group 2 (52/134, P < 0.01). Conclusions There arespecial characteristics in distribution and endoscopic manifestations of early colorectal carcinoma. Lesion size was less than 1 cm in 67(191 cases of early colorectal cancer) early colorectal carcinoma cases; however, a high-risk adenoma is defined as a lesion larger than1 cm in size. Therefore, regardless of lesion size, if fractionation, echinodermata, congestion, erosion, expansion, and depression areobserved, the lesion should be assessed in detail for the sake of carcinogenesis. |
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