不同结肠息肉内窥镜资料和癌变率的回顾性对比分析

本文回顾分析了本院1986年1月至1996年6月经活检、电切及手术病理证实的426例结肠息肉病人,共583枚息肉。结果显示:最常见的为炎性息肉、其次为管状腺瘤;息肉好发部位为直肠和乙状结肠。息肉好发年龄在50—69岁,肿瘤性息肉的平均年龄较肿瘤样息肉明显为高,而腺瘤癌变者平均年龄更高;各种肿瘤性息肉和幼年性息肉的直径均较炎性息肉和血吸虫卵性息肉等为大,而腺瘤癌变者直径更大;本组病例中发生癌变者均为腺瘤性息肉,占腺瘤病人的3.99%,其中管状腺瘤、乳头状腺瘤、混合性腺瘤癌变率分别为1.72%、30%、25%,女性乳头状腺瘤癌变率则高达44.44%。这提示对于年龄较大,息肉直径较大,腺瘤样息肉,尤其是乳头状腺瘤及混合性肿瘤应高度警惕其癌变可能,对女性乳头状腺瘤更要特别注意。

A Retrospective Analysis of the Endoscopic Data and Canceration Rate of Various Types of Colonic Polyps

In a retrospective analysis of 583 colonic polyps obtained from 426 patients in the period be- tween 1986 and 1996,the most frequent types found were inflammatory polyps(39.47%),fol- lowed by tubular adenomas(30.02%)and papillary adenomas(7.63%).Most of the the plopys were located in the rectum(34.13%),sigmoid colon(33.96%)and descending colon(12.52%); while transverse colon(11.49%),ascending colon(7.38)and ileocecum(0.51%)were less freguently locatad.The mean diameter of neoplastic polyp and juvenile polyp was relatively larger than that of the others,and the mean diameter of the canceraed polyp was the largest.The com- mon age of patients with colonic polyp was between 50 and 69 years old,and the mean age of pa- tients with neoplastic polyp was bigger than tkat of patients with inflammatory polyp and other tumor-like lesions,while the mean age of patients with cancerated polyp was the biggest.All cases of canceraed polyp were cases of adenoma,and the cancaration rate of adenomatoid polyp was 3. 99%,while the canceration rate of the tubular adenomas,papillary adenomas and tubulopapillary adenomas were 1.72%,30% and 25% respectively.The canceration rate of papillary adenomas was significantly higher in women(44.44%).