266例大肠息肉的临床病理研究

Clinical pathological study of 266 cases of colorectal polyp

目的研究大肠息肉的临床、病理特点及其癌变的相关因素,对大肠腺瘤的癌变风险进行分层,以决定随访方案,提高大肠癌的早期诊断率。方法回顾性分析研究266例大肠息肉的内镜下表现,临床病理特点及癌变的相关因素,对部分患者进行了内镜下治疗及随访。结果266例大肠息肉中,腺瘤性息肉164例,其中高危性腺瘤112例,癌变8例,低危性腺瘤52例,无癌变病例,高危性腺瘤的癌变率高于低危性腺瘤(P<0.05)。有蒂腺瘤、亚蒂腺瘤及无蒂腺瘤的癌变率无统计学意义(P>0.05)。增生性息肉38例、炎性息肉64例,均未发现癌变病例。结论高危性腺瘤的癌变率较高,应加强对此类患者的内镜下治疗及随访,低危性的癌变率较低,可根据肠镜及病理检查结果进行随访,增生性息肉、炎性息肉可不常规随访。

Aim To study the colorectaI polyps in clinical pathological features and cancerate relevant factors, and to analyze the cancerate risk stratification of colon adenoma to determine the follow-up programs, so as to improve the early diagnosis rate of colorectal cancer. Methods Retrospective analysis of was conducted 266 cases of colorectal polyps＇ endoscopic features,clinical pathological characteristics and cancer-related factors,some of whom had endoscopic treatment and follow-up. Results In 266 cases of colorectal polyps, 164 cases of adenomatous polyp,of which 112 cases of high-risk adenoma,8 cases of canceration,52 cases in low-risk adenoma,without canceration cases. The canceration rate in high-risk adenoma was higher than that in low-risk adenoma（ P 〈 0.05 ）. There was no statistically significance in caneeration rate of pedunculated adenomas, short pedicle adenomas and non-pedicled adenoma（ P 〉 0.05 ）. There were 38 cases of hyperplastic polyp,64 cases of inflammatory polyps, none of which were cancerated. Conclusions The canceration rate of highrisk adenoma is higher. Such patients should be enhanced endoscopic treatment and follow-up. That of low-risk adenoma is relatively low, and can be followed up in accordance with the colonoscopy results of pathological examination. Hyperplastie polyp and inflammatory polyp might not be followed up as usual.