大肠息肉临床与病理相关性研究

Correlational study between clinical characteristic and pathological type of colorectal polyps

目的探讨大肠息肉患者的年龄、息肉发生部位、大小和息肉病理类型及癌变的相关规律。方法分析我院2005年1月-2010年12月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。结果在4 630例肠镜检查患者中,发现大肠息肉824例,检出率为18%,其中,腺瘤性息肉495例,占60.1%;炎症性息肉193例,占23.4%;增生性息肉125例,占15.2%;幼年性息肉11例,占1.3%。不同病理分型的息肉分布部位比较,差异无统计学意义(P>0.05)。混合性腺瘤平均直径明显大于绒毛状腺瘤和管状腺瘤。本组共有25例息肉发生癌变,癌变率为3.03%。癌变患者息肉病理组织学均为腺瘤型,直径≥1.1 cm者21例,占84%。结论中老年人大肠息肉发病率较高;病理类型以腺瘤性息肉、炎症性息肉较常见;息肉直径≥1.1 cm或混合性腺瘤容易癌变;建议要重视36岁以后人群的肠镜检查。

Objective To explore the related laws of age of colorectal polyps patients,location and size of polyps,pathological category and cancerization of polyps.Methods The clinical manifestation,endoscopic features and pathological data in all patients diagnosed by colonoscopy were analyzed retrospectively,which collected from January 2005 to December 2010 in our hospital.Results Among a total of 4 630 cases,824 cases were diagnosed with colorectal polyps,the detection rate was 18%.Patients with adenomatous polyp,inflammatory polyp,hyperplastic polyp and juvenile polyp were 495,193,125,and 11 cases,accounting for 60.1%,23.4%,15.1% and 1.3% respectively.There was no significant difference between histopathology and location of colorectal polyps（P 0.05）.The mean diameter of tubulovillous adenoma was larger than that of tubular adenoma and villous adenoma.Malignant disease was found in 25 patients,the canceration rate was 3.03%.All the malignant polyps were adenocarcinoma in histopathology,diameter of 21 cases（84%） were larger than 1.1 cm.Conclusion Elder people more frequently suffer from colorectal polyps.Adenomatous polyps and inflammatory polyps are common histopathologies.Polyp with diameter more than 1.1 cm or tubuvillous adenoma tends to cause cancerization.It suggests that residents aged over 36 should undergo colonoscopy examination regularly.