大肠息肉内镜表现与病理特征及恶变关系研究

目的：探讨大肠息肉的内镜下表现与病理特征及其恶变的关系。方法：对门诊患者大肠镜普查发现的361例大肠息肉的内镜及病理特征作回顾性分析。结果：息肉恶变42例42枚（10.5%)。息肉≤5mm者无恶变，6-9mm者恶变率0.9%,10-19mm者恶变率11.8%,≥20mm者恶变率38.5%；腺癌性息肉恶变率9.7%，增生性息肉恶率4.5%，80例炎性息肉有1例恶变。绒毛状腺瘤性息肉是息肉恶变的高危因素，恶变率（19/80）23.8%；恶变的息肉内镜下均表现为宽蒂或无蒂，表达充血或糜烂。结论：息肉恶变与其大小、形态和组织病理类型相关，腺瘤性息肉体积越大，绒毛状结构越多，癌变机会越高；增生性息肉、炎性息肉亦有恶变；大肠息肉不论大小、性质应尽可能予以切除。

Correlation between endoscopic characteristics of colorectal polyps and pathologic feature and canceration

Objective To investigate the location, size, morphology and histopathology of colorectal polyps and the correlation of which with canceration. Methods The documents of 361 patients with bowel polyp s detec ted by scree ning colonoscopy performed on 2 764 consulting patients from 1995 to 1998 we re re trospectively reviewed and analyzed. Results Forty two polyps with malignent change in 42 patients were found. The rate of malignent change from be nign seemed dependent on its size, morthology and type of histopathology, being ≤5 mm, 0%; 6～9 mm, 0.9%; 10～19 mm，11.8%；≥20 mm, 38.5%;adenoma,9.7%;hyp erplastic polyp,4.5%; inflammantory polyp, 1/80; villous adenoma, 23.8%. Conclusion Polyp with bigger valume, more villous structure has more cr isis of malignent change. Hyperplastic polyp and inflammantory polyp have also m alignent change. Colorectal polyps is to be extirpated regardless of size and type.