结直肠锯齿状腺瘤内镜表现和病理学特征分析

目的探讨锯齿状腺瘤（SA）内镜下表现和病理学特征。方法回顾分析滨州医学院附属医院2000年1月～2008年5月检出的大肠息肉病例，了解SA的检出率、内镜形态和病理学特征。结果8726例肠镜检查共检出大肠息肉1062例（1457枚），检出率为12．17％，其中SA32例（60枚），检出率为0．37％，占息肉构成比为3．01％。SA直径〉1cm者占21．63％，明显大于增生性息肉（8．57％）；SA表现为有蒂息肉所占的比例（8．33％）略高于增生性息肉（5．71％），但都低于腺瘤性息肉（40．84％）。SA癌变率介于管状腺瘤和绒毛状腺瘤之间，接近于管状绒毛状腺瘤。结论SA内镜形态、病理学特点提示SA是兼有增生性息肉形态学特征和腺瘤性息肉组织学特点的息肉，具有恶变潜能.

Analysis of the characteristics of endoscopic appearances and histopathological features of colorectal serrated adenomas

Objective To explore the endoscopic and histopathological features of serrated adenomas （SA）. Methods The data of patients with colorectal polyps diagnosed in the Affiliated Hospital of Binzhou Medical College from January 2000 to May 2008 were reviewed. The detection rate, endoscopic appearances, and histopathological features of SA were analyzed. Results In 1 062 （ 12. 17% ） out of 8 726 patients undergoing colonoscopy, 1 457 polyps were found. Among them, 32 patients with 60 polyps were found, with a detection rate of 0.37%. The SA, larger than hyperplasic polyps obviously were found in patients 21.63% with diameter （larger than 1 cm）. The incidence of pedunculated polyps in SA（8.33% ） was higher than that in hyperplasic polyps （5.71%）, but less than that in adenomatous polyps （40.84%）. The incidences of severe dysplasia of SA were higher than those of tubular adenomas, but lower than villous adenomas, and it was similar to the tubulovillous adenoma. Conclusion The endoscopic appearances and his- topathological features of SA show that SA not only has morphological feature of hyperplastic polyps, but also has histo- logical characteristic adenomatous polyp, which has potential malignancy.