563例结直肠息肉临床内镜病理分析

目的探讨结直肠高危腺瘤及癌变息肉的临床及内镜病理特征,为合理的结肠镜检查随访提供依据。方法选择2003～2010年间肠镜检查并行内镜摘除结直肠息肉的患者563例,分为腺瘤组359例与非腺瘤组204例,腺瘤组中高危腺瘤162例、低危腺瘤组197例,分析其临床、内镜及病理特征。结果腺瘤组平均年龄高于非腺瘤组,差异有统计学意义(P0.05);腺瘤组出现便血比例高于非腺瘤组,腺瘤组中高危腺瘤患者便血比例明显高于低危组,两者差异均有统计学意义(P0.05);腺瘤组在息肉直径≥1cm、数量≥3个,腺瘤表面黏膜粗糙、糜烂和分叶,腺瘤上皮内瘤变和癌变的发生比例均高于非腺瘤组,差异均有统计学意义(P0.01)。结论高龄、便血是腺瘤的高危因素;高危腺瘤易发生癌变及癌前期病变,临床应重视其监测与随访。

Clinical analysis of 563 cases colorectal polyps

Objective To probe into the canceration factors for colorectal polyps and to investigate the endoscopic and pathologic characteristics of colorectal high-risk adenomas for a reasonable follow-up colonoscopy.Methods All 563 colon polyp patients underwent colonoscopic resection between 2003 and 2010 at the department of gastroenterology,No.2 hospital of Lu’an city.563 cases were divided into adenomatous polyps group which contained 359 cases and non-adenomatous polyps group which contained 204 cases,then adenomatous polyps were stratified into lower risk group with 197 cases and increased risk group with 162 cases.The clinical and pathologic features of endoscopy were analysed.Results The average age of adenomatous polyps patients were higher than that of the non-adenomatous polyps patients(P<0.05);the adenomatous polyps patients had higher incidence of hematochezia than that of the non-adenomatous polyps patients(P<0.05);the high-risk adenomas group had higher incidence of hematochezia(P<0.05),more lobular and mucosal pathological change than low-risk adenomas group(P<0.05).In our study,adenomatous polyps patients had canceration and high level intraepithelial neoplasia of change rate of polyps ≥1.0 cm in diameter and the number of polyps ≥3;lobular and mucosal pathological changes were significantly higher than non-adenomatous polyps patients(P<0.05).Conclusion Advanced age and hematochezia are high risk factors of the adenoma;advanced adenomas are easy to develop into cancerous and precancerous lesions.