大肠息肉679例临床特征及内镜、病理学特点分析

 目的 研究大肠息肉患者的年龄,息肉的发生部位、大小、病理类型以及息肉癌变的相关规律.方法 对电子肠镜检查中检出的大肠息肉患者的临床表现、内镜特点及病理资料进行总结和分析.结果 在3 680例肠镜检查者中,发现大肠息肉679例,其中男468例,女211例,检出率18.45%; 好发年龄以30～69岁为主,占80.41%;炎性、增生性、腺瘤性、错构瘤性、幼年性息肉分别占33.87%、32.11%、31.37%、1.77%、0.59%;息肉部位分别为直肠34.18%、乙状结肠23.12% 、降结肠14.96%、横结肠12.13%、升结肠11.49%、盲肠4.11%.679例大肠息肉患者中有30例发生癌变,癌变率为4.42%.管状腺瘤、混合性腺瘤、绒毛状腺瘤癌变率分别为5.88%、4.21 %、23.08%.息肉直径≤1.0 cm,无癌变发生;1.1～1.9 cm息肉,癌变率4.24%;≥2.0 c m息肉,癌变率21.37%.结论 30～69岁大肠息肉发病率较高,年龄大于50 岁为危险因素,男性较女性更容易患大肠息肉;息肉好发部位为左半结肠;病理类型以炎性息肉、增生性息肉和腺瘤性息肉常见;左半结肠、直径≥2.0 cm息肉、绒毛状腺瘤容易癌变 ;发现大肠息肉应尽可能切除,并应建立良好的随访机制,内镜下切除大肠息肉可预防息肉癌变.

Clinical,enteroscopic,and pathological characteristics of 679 cases of colorectal polyps

Objective To study the clinical, enterescopic and pathological characteristics of colorectal polyps and their malignant transformation. Methods The clinical, enteroscopic and pathological characteristics in 679 patients with colorectal polyps were reviewed. Results Of 3 680 patients undergoing coloscopy, colorectal polyps were found in 679 patients, including 468 men and 211 women, with a detectable rate of 18.45 %. The incidence rate of colorectal polyp was 80.41% in 30 - 69 year olds. The inflammatory, hyperplastic, adenomatous, hamartomatous, and juvenile polyps accounted for 33.87 %, 32.11%, 31.37 %, 1.77 %, and 0. 59 %, respectively. Polypoid lesions were located at rectum （34.18 % ）, sigmoid（23.12 % ）, descending colon （ 14.96 % ）, transverse colon （ 12.13 % ）, ascending colon （ 11.49 % ）, and cecum （4.11% ）. Thirty cases （4.42 % ） were found to have canceriation of polyps. The canceriation rates in tubular, mixed, and villous adenomas were 5.88% ,4.21% ,and 23.08% ,respectively. The rate of polyp canceriation seemed to depend on its size,the greater the diameter, the higber thecanceration rate：0 for≤〈1.0cm,4.24% for 1.1-1.9cm,and 21.37% for≥2.0 cm in diameter.Conclusions Tbe ages between 30-69 tend to suffer from colorectal polyps,over 50 years may be a risk factor. Colorectal polyps are frequently observed in left colon;more often in men than in women. The common pathological types are inflammatory,hyperplastic, and adenomatous polyps. Villous adenomatous polyps in the left colon, ≥ 2.0 cm in diameter are liable to canceration. All the colorectal polyps should be excised and undergo the pathological examination. Endoscopic polypectomy helps prevent colorectal polyp canceriation.