不同年龄组大肠息肉检出率及临床内镜的相关性研究

Correlative Research of the Detection Rate Large Bowel Polyp and Endoscopic Examination in Different Age Groups

目的:探讨不同年龄组大肠息肉检出率、临床、内镜特点及与癌变的关系。方法:按年龄分为青年组(≤35岁),中年组(36～59岁),老年组(≥60岁)。比较不同年龄组大肠息肉患者的临床表现、镜下表现、病理类型,对其中老年组的80例进行1～5a(平均3.5a)的结肠镜随访,并与青中年组的138例患者相对照。结果:青年组大肠息肉的检出率、癌变率均明显低于老年组及中年组,随年龄增长检出率有逐渐增加的趋势;分布以直肠和乙状结肠多见;病理类型以腺瘤性息肉为多;息肉基底宽、体积大、数量多,癌变率高。结论:大肠息肉以老年组多见,腺瘤性息肉的大小、形态、数量及病理类型是癌变的主要危险因素,大肠息肉者尽可能镜下摘除,定期随访,减少癌变机会。

Objective:To explore the characteristics of colonic polyps in different aged people, and its correlation with canceration.Methods:Patients were divided into young(≤35 years),mid-aged (36~59 years),and aged (≥60 years) groups.The clinical data and endoscopic features as well as pathologic results were compared.80 patients in the aged group had been followed up by endoscopy for 1 to 5 years(average 3.5 years) and the data were compared with other 138 patients in the other two groups.Results:The detection rate and the malignant change rate of colonic polyps in the young people were significantly lower than those in the aged and midaged people, and the detection rate showed gradually increasing trend with the increase of age;The colonic polyps in elderly people usually occured in rectum and sigmoid colon. The colonic polyps in the aged group were predominantly adenomatous polyps ;The larger in size?the broader in fundus and the more in number, the higher frequency of malignancy of the polyps.Conclusion:In the elderly paitents with clonic polyps,the size, morphology,numbers and pathological types were most significant risky factors for malignant change. Elderly people with the positive detection should be examined by endoscopy for all colon and be followed-up periodically in case of malignant transformation.