结肠息肉癌变相关因素分析

目的　更好地认识癌变息肉的临床特点 ,找出与癌变息肉相关的因素 ,为临床初步判断息肉的性质提供依据。方法　回顾整理连续 4年内资料完整可用的结肠息肉病例 ,分析性别、年龄、息肉部位、数目、是否有蒂、黏膜情况、是否分叶、病理类型、息肉大小、不典型增生程度等因素。结果　单因素分析显示癌变与未癌变息肉在大小、黏膜情况、不典型增生程度、病理类型、是否分叶状等因素方面的差别具有统计学意义。逐步Logistic分析显示与癌变息肉独立相关的因素包括息肉大小、不典型增生程度、黏膜情况、是否有蒂及病理类型。结论　息肉越大、病理为腺瘤、不典型增生程度越重、黏膜有糜烂甚至溃疡、亚蒂或无蒂是与癌变息肉独立相关的因素 ,以上因素符合的越多则该息肉为恶性的可能性越大

ANALYSIS OF RELEVANT FACTORS OF MALIGNANT DEGENERATION OF COLORECTAL POLYPS

Objective To retrospectively analyse the factors related to the risk of malignant change in relation with various colorectal polyps. Methods Data on a total of 820 patients (900 polyps), who had undergone polypectomy between 1997 and 2001 were collected. The relation between colorectal cancer and polyps characteristics was assessed by Logistic Regression and Chi square. Results The risk of malignant change was significantly related with the size of polyps, histology of polyps, grade of dysplasia, pathological changes of mucosa, sessile or pedunculated polyps. Conclusion High grade dysplasia, large size, adenoma, absence of a stalk, and ulcerous mucosa were confirmed as the major predictors. The likelihood of malignant degeneration of colorectal polyps seemed to be correlated with the number of the above mentioned risk factors present