侧方扩展型大肠肿瘤的X线特征

Radiological features of laterally spreading tumor of colon and rectum

目的:探讨扩展型大肠肿瘤的X线与病理学特征。方法:分析了经组织病理学证实的46例54处病变的X线钡灌肠造影表现和内镜图像,将病变分为非结节扁平隆起、结节集簇性隆起和混合性结节集簇隆起3种类型,与病理组织学进行对照研究。结果:扩展型大肠肿瘤好发于直肠、盲肠和升结肠近段,组织病理学多为腺瘤或黏膜内癌,混合结节集簇隆起型病变癌变率高、浸润较深,且有进展期癌。结论:扩展型大肠肿瘤表面的形态改变,可以作为推测有无癌变与癌变浸润深度的指标。

Objective：To investigate the radiological and pathological characteristics of laterally spreading lesion of colon and rectum. Methods： The radiological and endoscopic findings of laterally spreading tumor （LST） with complete data of pathological conformation of 46 cases with 54 lesions were analyzed. The lesions were classified on the basis of surface appearance into three subtypes according to the manifestation： flat elevation with flat nodule （14 lesions）, nodule aggregating （34 lesions）, and nodule aggregating with distinct depressed or protruded or no structured area （6 lesions）. The morphological features were studied corresponding to the pathological findings. Results： The predilection for location of LST was rectum, cecum and oral segment of ascending colon. The most lesions were adenoma or cancer confined in mucosa, but the incidence of cancer was high and infiltration was deeper with some of advanced cancer in the subtype of nodule aggregating with distinct depressed or protruded or no structured area. Conclusion： The changes of tumor surface of LST may be a useful index for cancerous component and the depth of invasive of carcinoma.