大肠锯齿状腺瘤与传统腺瘤部分临床特征比较

Clinical features of serrated adenoma of the large bowel:comparison with traditional adenoma

目的:了解大肠锯齿状腺瘤是否存在不同于传统腺瘤的临床特征。方法:回顾我院病理科自2002年11月至2005年12月期间所有的大肠息肉切片,重新诊断锯齿状腺瘤,然后比较其与传统腺瘤在患者年龄、性别、病变部位、息肉大小及蒂部情况等方面有无差异。结果:共检出1200张大肠息肉切片,其中锯齿状腺瘤29例,占全部息肉2.42%。比较传统腺瘤与锯齿状腺瘤的部分临床特征,发现锯齿状腺瘤患者平均年龄较传统腺瘤患者小[(56.0±16.6)岁vs(62.7±13.2)岁,P=0.0336];在直乙结肠,锯齿状腺瘤的发生率要高于传统腺瘤(62%vs35%,P=0.0252),而在降结肠则刚好相反(0vs25%,P=0.0068),其余部位二者构成比差异无显著性;在性别组成及息肉平均直径、蒂部情况二者差异亦无显著性(P>0.05)。结论:锯齿状腺瘤在临床较少见,其与传统腺瘤在发生年龄及发生部位方面存在差异,有必要对其发生的分子机制及预后深入研究。

Objective To observe the clinical features of serrated adenoma and to compare with traditional adenoma of the large bowel. Methods All colorectal polyp slices were reviewed in department of pathology of our hospital from November 2002 to December 2005 and were re-diagnosed for serrated adenoma. The patients＇age, gender and the lesions＇ location, size and pedicle were compared between the two kinds of polyp. Results There were 1 200 colorectal polyp slices totally, in which 29 serrated adenomas （2.42%） were found. The serrated adenoma patients were younger than the traditional adenoma patients （56.0 vs 62.7, P = 0.033 6）, and more frequently found in the rectosigmoid colon than the traditional adenomas （62% vs 35%, P = 0.025 2）, however, the situation was opposite in descending colon （0 vs 25%, P = 0.006 8）, and then there wasn＇t any difference between the two polyps in other part of the colon. They also didn＇t have any difference on the patient＇s gender and the polyps＇ size and pedicles＇ situation （P 〉 0.05）. Conclusions Serrated adenoma is scarce. It is different from traditional adenoma on the patient＇s age and lesion＇s location. It is necessary to study this lesion＇s molecular mechanism and prognosis.