老年人Barrett食管的内镜表现及病理特征分析

Objective To explore the similarities and differences in endoscopic and pathological characteristics between elderly and non-elderly patients with Barrett esophagus (BE). Methods Three hundred and seventy-one cases with BE were divided into elderly group (n=254) and nonelderly group (n=117). The detection rate, endoscopic findings and pathological changes were assessed. Results The detection rate of BE was 2.9% in the elderly, and 0. 9% in the non-elderly(χ2 =127.8, P＜0.01). The 112 cases (44.1%) of the elderly had reflux symptoms, and so did 87cases (66.7%) of the non-elderly (χ2 =55.9, P＜0.01). The detection rate of BE in the two groups was increased year by year from 2004 to 2008. The detection rate of ring pattern was significantly higher in elderly group than in non-elderly group (28.7% vs. 10.3%, χ2=14.5, P＜0.01). Nonelderly patients had higher rate of island pattern than elderly patients (59.5% vs. 71.7%, χ2=4.7,P＜0.05). There were significant differences in the rate of specialized intestinal metaplasia between elderly and non-elderly patients (42.1% vs. 27.4%, χ2=6.9, P＜0.01). The difference in low and medium grade intraepithelial neoplasm between the two groups had statistical significance (21.3% vs.11.1%, χ2=4.9, P＜0.05). There were two cases with adenocarcinoma in elderly group, but no case was found in non-elderly group. The detection rate of H. pylori was comparable between elderly group and non-elderly group (35.5% vs. 40.9%, χ2=0.40, P＞0.05). Conclusions The elderly patients have the 3.2 times higher detection rate of BE than non-elderly patients. The detection rates of specialized intestinal metaplasia and intraepithelial neoplasm are higher in elderly group than in nonelderly group.     

老年人Barrett食管的内镜表现及病理特征分析

Objective To explore the similarities and differences in endoscopic and pathological characteristics between elderly and non-elderly patients with Barrett esophagus (BE). Methods Three hundred and seventy-one cases with BE were divided into elderly group (n=254) and nonelderly group (n=117). The detection rate, endoscopic findings and pathological changes were assessed. Results The detection rate of BE was 2.9% in the elderly, and 0. 9% in the non-elderly(χ2 =127.8, P＜0.01). The 112 cases (44.1%) of the elderly had reflux symptoms, and so did 87cases (66.7%) of the non-elderly (χ2 =55.9, P＜0.01). The detection rate of BE in the two groups was increased year by year from 2004 to 2008. The detection rate of ring pattern was significantly higher in elderly group than in non-elderly group (28.7% vs. 10.3%, χ2=14.5, P＜0.01). Nonelderly patients had higher rate of island pattern than elderly patients (59.5% vs. 71.7%, χ2=4.7,P＜0.05). There were significant differences in the rate of specialized intestinal metaplasia between elderly and non-elderly patients (42.1% vs. 27.4%, χ2=6.9, P＜0.01). The difference in low and medium grade intraepithelial neoplasm between the two groups had statistical significance (21.3% vs.11.1%, χ2=4.9, P＜0.05). There were two cases with adenocarcinoma in elderly group, but no case was found in non-elderly group. The detection rate of H. pylori was comparable between elderly group and non-elderly group (35.5% vs. 40.9%, χ2=0.40, P＞0.05). Conclusions The elderly patients have the 3.2 times higher detection rate of BE than non-elderly patients. The detection rates of specialized intestinal metaplasia and intraepithelial neoplasm are higher in elderly group than in nonelderly group.     

Polyp detection rate and pathological features in patients undergoing a comprehensive colonoscopy screening

AIM To identify the prevalence, and clinical and pathologic characteristic of colonic polyps among Iranian patients undergoing a comprehensive colonoscopy, and determine the polyp detection rate(PDR) and adenoma detection rate(ADR).METHODS In this cross-sectional study, demographics and epidemiologic characteristics of 531 persons who underwent colonoscopies between 2014 and 2015 at Mehrad gastrointestinal clinic were determined. Demographics, indication for colonoscopy, colonoscopy findings, number of polyps, and histopathological characteristics of the polyps were examined for each person.RESULTS Our sample included 295(55.6%) women and 236(44.4%) men, with a mean age of 50.25 ± 14.89 years. Overall PDR was 23.5%(125/531). ADR and colorectal cancer detection rate in this study were 12.8% and 1.5%, respectively. Polyps were detected more significantly frequently in men than in women(52.8% vs 47.2%, P 0.05). Polyps can be seen in most patients after the age of 50. The average age of patients with cancer was significantly higher than that of patients with polyps(61.3 years vs 56.4 years, P 0.05). The majority of the polyps were adenomatous. More than 50% of the polyps were found in the rectosigmoid part of the colon.CONCLUSION The prevalence of polyps and adenomas in this study is less than that reported in the Western populations. In our patients, distal colon is more susceptible to developing polyps and cancer than proximal colon.     

Gallbladder polyps: Factors affecting surgical decision

AIM: To determine the factors affecting the decision to perform surgery, and the efficiency of ultrasonography (USG) in detecting gallbladder polyps (GP). METHODS: Data for 138 patients who underwent cholecystectomy between 1996 and 2012 in our clinic with a diagnosis of GP were retrospectively analyzed. Demographic data, clinical presentation, principal symptoms, ultrasonographic and histopathological findings were evaluated. Patients were evaluated in individual groups according to the age of the patients (older or younger than 50 years old) and polyp size (bigger or smaller than 10 mm) and characteristics of the polyps (pseudopolyp or real polyps). χ 2 tests were used for the statistical evaluation of the data. RESULTS: The median age was 50 (26-85) years and 91 of patients were female. Of 138 patients who underwent cholecystectomy with GP diagnosis, only 99 had a histopathologically defined polyp; 77 of them had pseudopolyps and 22 had true polyps. Twenty-one patients had adenocarcinoma. Of these 21 patients, 11 were male, their median age was 61 (40-85) years and all malignant polyps had diameters > 10 mm (P< 0.0001). Of 138 patients in whom surgery were performed, 112 had ultrasonographic polyps with diameters < 10 mm. Of the other 26 patients who also had polyps with diameters > 10 mm, 22 had true polyps. The sensitivity of USG was 84.6% for polyps with diameters > 10 mm (P < 0.0001); however it was only 66% in polyps with diameters < 10 mm. CONCLUSION: The risk of malignancy was high in the patients over 50 years old who had single polyps with diameters > 10 mm.     

老年人消化性溃疡出血的相关危险因素分析

Objective To explore the risk factors for peptic ulcer bleeding in elderly patients.Methods The 414 patients with upper gastrointestinal ulcer bleeding in Xuanwu Hospital from January 2001 to January 2006 were enrolled.The patients were divided into elderly group (≥ 60years,n= 183 ) and non-elderly group ( ＜ 60 years,n= 231 ).The coexisting diseases and hemorrhage causes were compared and analyzed.Results The detection rate of coexisting diseases was significantly higher in elderly group than in non-elderly group (68.9% vs.10.0% ).The hemorrhage causes included the taking of drugs for cardiovascular and cerebrovascular diseases or osteoarthropathy in elderly group.And the fatigue,stress and dietary upset were the main causes in non-elderly group.Helicobacter pylori infection rate was 35.0% in the elderly and 58.0% in young patients.Conclusions It is very important to promote rational use of anticoagulant drugs and analgesic agents in elderly patients for managing peptic ulcer complication.     

Does hyoscine butylbromide really improve polyp detection during colonoscopy? A meta-analysis of randomized controlled trials

AIM:To investigate the benefits of hyoscine butylbromide in polyp detection during colonoscopy by a meta-analysis of available randomized controlled trials(RCTs).METHODS:Databases,including PubMed,EMBASE,the Cochrane Library,and the Science Citation Index up to September 2013,were searched.The primary outcome was polyp detection rate,and the secondary outcome was adenoma detection rate.The metaanalysis was performed using the free software Review Manager.Differences observed between the treated and the control groups were expressed as odds ratio(OR)with a 95%confidence interval(CI).A fixedeffects model was used to pool data when statistical heterogeneity was absent.If statistical heterogeneity was present(P<0.05),a random-effects model was used.RESULTS:The initial search identified nine articles.After screening,five RCTs with a total of 1998 patients were included in this meta-analysis.Of the five studies,all described a comparison of baseline patient characteristics and showed that there was no statistically significant difference between the two groups.Among the 1998 patients,1006 received hyoscine butylbromide and 992 were allocated to the control group,and the polyp detection rate was reported.There were no significant differences between the treated and the control group(OR=1.09,95%CI:0.91-1.31,P=0.33).Four RCTs included 1882 patients,of whom948 received hyoscine butylbromide,and the adenoma detection rate was reported.There were no significant differences between the treated and the control group(OR=1.13,95%CI:0.92-1.38,P=0.24).CONCLUSION:The use of hyoscine butylbromide did not significantly improve the polyp detection rate during colonoscopy.     

Histologic characteristics of gastric polyps in Korea： Emphasis on discrepancy between endoscopic forceps biopsy and endoscopic mucosal resection specimen

AIM: To investigate histological characteristics of gastric polyps in the Korean population. METHODS: We reviewed endoscopic photographs and medical records of patients with gastric polyps who underwent endoscopic mucosal resection from April 1996 through February 2003. RESULTS: A total of 85 gastric polyps from 74 patients were reviewed. Male-to-female ratio was 1:1.96. Mean age was 59.9±10.8 years. Multiple polyps were observed in 10.8%. Gastric polyps occurred most frequently in the antrum (58.8%). Pathological results on resected specimens were as follows: tubular adenoma 45.9%, hyperplastic polyp 31.8%, inflammatory polyp 9.4%, hamartoma 3.5%, fundic gland polyp 2.4%, tubulovillous adenoma 2.4%, adenocarcinoma 2.4%, dysplasia 1.1%, and mucosal pseudolipomatosis 1.1%. Discrepancy rate between endoscopic biopsy and pathology of resected specimens was 27.1%. There was no relationship between the size of the polyp and concordance rate. CONCLUSION: There is considerable discrepancy in histologic findings between endoscopic forceps biopsy and resected specimens. Approaches to review of the histology of an entire polyp should be performed, especially when an adenoma is suspected.     

Feasibility of full-spectrum endoscopy:Korea’s first full-spectrum endoscopy colonoscopic trial

AIM: To evaluate the full-spectrum endoscopy(FUSE) colonoscopy system as the first report on the utility thereof in a Korean population.METHODS: We explored the efficacy of the FUSE colonoscopy in a retrospective, single-center feasibility study performed between February 1 and July 20, 2015. A total of 262 subjects(age range: 22-80) underwent the FUSE colonoscopy for colorectal cancer screening, polyp surveillance, or diagnostic evaluation. The cecal intubation success rate, the polyp detection rate(PDR), the adenoma detection rate(ADR), and the diverticulum detection rate(DDR), were calculated. Also, the success rates of therapeutic interventions were evaluated with biopsy confirmation.RESULTS: All patients completed the study and the success rates of cecal and terminal ileal intubation were 100% with the FUSE colonoscope; we found 313 polyps in 142 patients and 173 adenomas in 95. The overall PDR, ADR and DDR were 54.2%, 36.3%, and 25.2%, respectively, and were higher in males, and increased with age. The endoscopists and nurses involved considered that the full-spectrum colonoscope improved navigation and orientation within the colon.No colonoscopy was aborted because of colonoscope malfunction.CONCLUSION: The FUSE colonoscopy yielded a higher PDR, ADR, DDR than did traditional colonoscopy, without therapeutic failure or complications, showing feasible, effective, and safe in this first Korean trial.     

Role of computed tomographic colonoscopy of postoperative surveillance in patient with gastric cancer

AIM: To examine the diagnostic yield of colorectal neoplasia at computed tomographic colonoscopy (CTC) as well as the feasibility of contrast enhanced CTC in patients with gastric cancer. METHODS: To examine the incidence of colon polyp we selected postoperative 188 gastric cancer patients, which we refer to as the 'colon polyp survey group'. To examine the feasibility of CTC for early detection of colon cancer or advanced colon adenoma, we selected 47 gastric cancer patients (M:F 29:18, mean age 53.8 years), which we call the 'CT colonoscopy group'. All the 47 patients underwent successive CTC and colonoscopy on the same day. RESULTS: Totally 109 colon polyps were observed from 59 out of 188 gastric cancer patients, the incidence rate of colon polyps in gastric cancer patients being 31.4%. The sensitivity of CTC in detecting individuals with at least 1 lesion of any size was 57.1%, the specificity was 72.7%, the positive predictive value was 47.1%, and the negative predictive value was 71.9%. When the cutoff size was decreased to 6 mm, the sensitivity and specificity were 80.0% and 92.9%, respectively, with positive and negative predictive values of 57.1% and 97.5%, respectively. Only one patient was classified as false negative by virtual colonoscopy. CONCLUSION: The diagnostic yield of colorectal polyp was 31.4% in patients with gastric cancer, and contrast enhanced CTC is an acceptable tool for the detection of synchronous colorectal advanced adenoma andpostoperative surveillance of gastric cancer patients.     

老年人消化性溃疡出血的相关危险因素分析

Objective To explore the risk factors for peptic ulcer bleeding in elderly patients.Methods The 414 patients with upper gastrointestinal ulcer bleeding in Xuanwu Hospital from January 2001 to January 2006 were enrolled.The patients were divided into elderly group (≥ 60years,n= 183 ) and non-elderly group ( ＜ 60 years,n= 231 ).The coexisting diseases and hemorrhage causes were compared and analyzed.Results The detection rate of coexisting diseases was significantly higher in elderly group than in non-elderly group (68.9% vs.10.0% ).The hemorrhage causes included the taking of drugs for cardiovascular and cerebrovascular diseases or osteoarthropathy in elderly group.And the fatigue,stress and dietary upset were the main causes in non-elderly group.Helicobacter pylori infection rate was 35.0% in the elderly and 58.0% in young patients.Conclusions It is very important to promote rational use of anticoagulant drugs and analgesic agents in elderly patients for managing peptic ulcer complication.     

老年人大肠息肉的临床分析

目的 探讨老年人大肠息肉的临床特点及其与癌变的关系。方法 对我院经结肠镜检出的158例老年大肠息肉患者的临床特点进行回顾性分析，对其中120例进行1－6年（平均4．5年）的结肠镜随访，并与青中年组的437例患者相对照。结果 老年人大肠息肉的检出率、癌变率分别为30．0％及23．4％，均显著高于中青年组的10．2％及6．9％（P＜0．01），随年龄增长检出率有逐渐增加的趋势。分布以直肠和乙状结肠多见，但升结肠的癌变率（37．5％）明显高于左半结肠（14．3％，P＜0．05），且直肠、降结肠、横结肠及升结肠的癌变率也显著高于青中年组的同一部位（P＜0．01）；病理类型以腺瘤性息肉为多，占77．6％，也明显高于青中年组的同一病理类型（P＜0．01）。37例癌变息肉均为腺瘤性息肉，其中绒毛状腺瘤的癌变率（56．9％）显著高于管状腺瘤（3．4％，P＜0．01）。息肉体积大（＞2cm)、基底宽、数量多，癌变率高。腺瘤性息肉经内镜下摘除者其癌变率明显低于未摘除者（P＜0．01）。结论 老年人大肠息肉中的腺瘤性息肉的大小、形态、数量及病理类型是其癌变的主要危险因素，老年人应尽量行全结肠检查，检出大肠息肉者应尽可能首选肠镜下摘除，定期随访，减少癌变的机会。     

胃息肉的临床病理特征和内镜治疗随访观察

背景：胃息肉是一种常见病,病因不明且有癌变的可能。目的：分析胃息肉的临床、内镜、病理特征和内镜治疗效果。方法：对2006年7月1日～2009年7月1日于空军总医院接受胃镜检查,诊断为增生性息肉、腺瘤性息肉和胃底腺息肉的患者进行回顾性分析。结果：共检出三种常见类型的胃息肉392例,检出率为3.4％,单发283例,多发109例。61．5％的患者位于30～59岁年龄段．53．1％的患者息肉形态为山田Ⅱ型,64．0％的患者息肉最大径≤0．5cm。365例行病理检查者中,增生性、腺瘤性和胃底腺息肉分别占63．6％、5．5％和31．0％,前两者好发于胃窦部,后者好发于胃体、胃底部。383例患者成功接受内镜治疗。75例有随访资料者中20例复发,其中13例为多发息肉。结论：胃息肉内镜下多为山田Ⅱ型,直径较小,多为单发．病理类型上以增生性息肉和胃底腺息肉多见。多发息肉治疗后易复发。     

老年人与中青年人大肠息肉临床特点对比研究

目的 探索老年人大肠息肉的临床特征.方法 收集在上海中医药大学附属曙光医院2006年1月-2019年12月行电子结肠镜检查并且病理证实为大肠息肉的患者1 000例,进行回顾性研究,按年龄分为老年组576例,中青年组424例.统计分析老年大肠息肉患者的临床症状、息肉大小、形态、部位、数目、息肉病理分型及其与息肉癌变的相关...     

老年人胃息肉的临床特点分析

目的 总结胃镜下胃息肉的临床和病理资料,探讨老年人胃息肉的临床特点.方法 对692例胃镜及病理确诊的胃息肉患者进行回顾分析,按年龄分为老年组(≥60岁)和中青年组(<60岁),以SPSS软件进行数据处理.结果 老年组患者胃息肉检出率为3.9%,中青年组为2.9%(x2=15.792,P<0.01).老年组胃底、胃体、胃窦息肉所占比例分别为32.0%、41.3%、19.8%,中青年组为37.5%、45.8%、11.1%(x2值分别为2.277、1.404、10.289,P值分别为0.131、0.236、0.001).胃息肉的病理类型依次为胃底腺60.0%,增生性26.2%,炎性11.3%,腺瘤性1.7%,其他0.8%.增生性息肉在老年组和中青年组的比例分别为31.7%和21.9%,腺瘤性息肉分别为3.0%和0.8%(x2值分别为8.525、4.834,P值分别为0.004、0.028).结论 老年组与中青年组比较,胃息肉的检出率偏高.两组胃息肉均以胃体、胃底多发,胃窦次之;老年组胃窦息肉的检出率明显高于中青年组.虽然两组胃息肉的病理类型均以胃底腺息肉为主,但老年组增生性息肉和腺瘤性息肉的检出率高于中青年组,癌变的风险较大.因而,老年组患者胃息肉应积极去除,并密切随访.     

胃息肉的临床病理特征及其与癌变和幽门螺杆菌感染关系的研究

目前对胃息肉的研究远不及结肠息肉,胃息肉与癌变以及幽门螺杆菌（H．pylori）感染的关系存在较多争议。目的：总结胃息肉的临床病理特征,并分析不同类型胃息肉与癌变和H．pylori感染的关系。方法：回顾性分析北京大学第三医院2003年1月～2008年12月经病理检查证实的胃息肉患者,分析不同类型胃息肉与肠化生、异型增生和癌变以及H．pylori感染的关系。结果：共检出1825例胃息肉患者,检出率4.3％。男女之比为l：2.3,663％为单发性息肉;胃底腺息肉、增生性息肉、腺瘤性息肉、炎性息肉和并发息肉（2种息肉同时发生于同一病例）分别占62．5％、32．2％、0．8％、1．7％和2．8％。贲门、胃底体和胃窦是增生性息肉较常见的发生部位。增生性息肉肠化生率和异型增生率均显著高于胃底腺息肉（5．3％对0．2％,7．2％对0．4％,P〈0．001）。2例增生性息肉发生癌变,癌变率0.3％。增生性息肉H．pylori感染率显著高于胃底腺息肉（36．5％对8．0％,P〈0．001）。结论：胃息肉检出率较低,以胃底腺和增生性息肉多见,并发息肉并非罕见。增生性息肉的肠化生率、异型增生率和H．pylori感染率均高于胃底腺息肉．且其可发生癌变。增生性息肉的发生可能与H．pylori感染有关。     

老年人Barrett食管的内镜表现及病理特征分析

目的 探讨老年人与非老年人Barrett食管(Barrett's esophagus,BE)的内镜表现及病理特征.方法 将371例BE患者根据年龄分老年组(254例)和非老年组(117例),并对其内镜表现及病理特征进行对比分析.结果 老年组和非老年组BE检出率分别为2.9%和0.9%(χ2=127.8,P＜0.01).2004-2008年,老年组与非老年组BE检出率均呈逐年上升趋势.老年组中有典型反流症状者112例(44.1%),非老年组8718例(66.7%),差异有统计学意义(χ2=55.9,P＜0.01).老年组全周型BE所占比例较非老年组高,差异有统计学意义(28.7%对10.3%,χ2=14.5,P＜0.01),非老年组岛型所占比例较老年组高,差异有统计学意义(59.5%对71.7%,χ2=4.7,P＜0.05).老年组特异性肠化发生率(42.1%),较非老年组(27.4%)明显升高(χ2=6.9,P＜0.01).老年组中轻中度上皮内瘤变的发生率较非老年组高,差异有统计学意义(χ2=4.9,P＜0.05).老年组中有2例腺癌,而非老年组未检出腺癌.老年组食管下段Hp检出率为35.5%(65/183),非老年组为40.9%(27/66),两组比较差异无统计学意义(χ2=0.40,P＞0.05).结论 老年人BE检出率高于非老年人,老年BE患者特异性肠化生及上皮内瘤变的检出率高于非老年人患者,临床应加强对老年高危人群的随访.     

大肠息肉部位、大小、形态等与病理分型的关系

目的探讨大肠息肉部位、大小、形态、数目部与病理类型的关系。方法经结肠镜检查诊断200例结肠息肉情况与病理检查进行分析。结果在≤1cm的息肉中以炎性息内较多见，在〉lcm的息肉中以腺瘤性息肉较多见。息肉恶变均发生在1cm以上，尤其是〉2cm的息肉。在有蒂息肉中以炎性较多见，均为良性，无蒂息肉中以腺瘤性较多见。最常发生于直肠和乙状结肠的息肉以炎性较多见；近端结肠的息肉，腺瘤性相对较多。单发息肉中多数是炎性息肉，多发息肉中多数是腺瘤性息肉。结论大肠息肉的部位和大小与病理类型有关。     

结直肠息肉发病风险预测模型构建及其临床价值

目的探讨行结肠镜检查者罹患结直肠息肉的相关危险因素并构建预测模型。 方法回顾性分析2019年1月至2021年10月于南京中医药大学第二附属医院行结肠镜检查者共1 671例的临床资料。根据结肠镜结果将968例结直肠息肉患者纳入息肉组，703名无息肉病变的患者纳入无息肉组。收集患者年龄、性别、身高、体重、吸烟史、饮酒史、实验室检查结果和既往肠镜检查结果等多种因素，分析影响结直肠息肉发生的相关危险因素。应用R语言建立预测结直肠息肉发生风险的列线图模型，用Bootstrap法进行模型内部验证，采用列线图验证曲线及ROC曲线评价列线图的预测性能。 结果息肉组患者年龄（t=151.531，P＜0.001）、男性比例（χ²=50.843，P＜0.001）、长期吸烟史比例（χ²=5.034，P=0.013）、BMI（t=0.813，P＜0.001）、既往息肉史（χ²=8.323，P=0.004）高于无息肉组，差异有统计学意义。多因素Logistic回归模型分析结果显示：年龄，性别，BMI，长期吸烟，既往息肉大小、病理类型及生长位置为结直肠息肉发病的独立危险因素（均P＜0.05）。ROC曲线显示AUC为0.908，敏感性和特异性分别为76.9%和83.2%。 结论年龄，性别，长期吸烟史，BMI，既往息肉大小、病理类型及生长位置为结直肠息肉发病的独立危险因素。该研究所建立的列线图模型具有良好的区分度和准确度，可为直观、个体化地分析结直肠息肉发生风险，甄别高危人群，为临床制订筛查方案提供参考依据。     

新疆地区胆囊息肉样病变331例临床分析

目的对胆囊息肉样病变(PLG)的临床特征进行分析,并探讨手术切除指征。方法对2008年8月-2013年12月新疆医科大学第四附属医院331例住院已经手术的PLG患者资料进行回顾性分析。组间率的比较采用卡方检验。结果 331例手术病例中,肿瘤性息肉13例(3.9%),非肿瘤性息肉318例(96.2%);将肿瘤组与非肿瘤组的临床特征进行对比,发现性别(χ2=6.2,P=0.013)、年龄(≥40岁/40岁)(χ2=3.90,P=0.048)、息肉大小(≥10 mm/10 mm)(χ2=77.4,P0.000 1)、病灶数目(多发/单发)(χ2=6.2,P=0.013)、息肉基底宽度(≥6 mm/6 mm)(χ2=111.8,P0.000 1)、是否合并胆囊结石(χ2=7.5,P=0.006)在2组间分布差异具有统计学意义。结论症状是决定手术指征的一个单独因素,有症状即应手术。大多数胆囊息肉恶变率低,年龄≥40岁、直径≥10 mm的单发息肉、息肉基底宽≥6 mm、近期增大明显、息肉合并结石等肿瘤相关因素,也是胆囊切除的手术指征。     

Solitary juvenile polyp developing adenocarcinoma with submucosal invasion

Solitary juvenile polyps are generally non‐neoplastic hamartomatous polyps. Inflammation is suggested as the cause of proliferation and progression of these polyps, and adenomatous and carcinomatous changes are rare. We report a rare case of a solitary juvenile polyp with malignant transformation that developed in the sigmoid colon of a 12‐year‐old boy. A 3 cm, pedunculated polyp was endoscopically resected, and histologic evaluation revealed the characteristic features of a juvenile polyp. However, mucous‐filled ectatic glandular spaces were lined by mucin‐secreting columnar epithelial cells with atypical change, and an admixture of adenocarcinoma invading the submucosa was confirmed. The histologic features may suggest the involvement of the adenoma–carcinoma sequence in the development of adenocarcinoma in the present case. Although rare, solitary juvenile polyps should develop adenocarcinoma and thorough histologic evaluation of the resected polyps is warranted to identify the adenomatous tissue.