不同年龄段结肠息肉的内镜及病理特征分析

Endoscopic and pathologic characteristics analysis of colon polyps in different ages

目的探讨不同年龄组结肠息肉的大小、生长方式及病理特点,为临床诊治提供客观依据。方法回顾性分析同济大学附属东方医院2009年1月～2011年8月行电子结肠镜检查发现的1083例结肠息肉患者的资料。根据检查结果,比较不同年龄段患者的息肉检出率以及肠息肉的大小、数目、病理类型等特点。结果结肠息肉检出率随年龄的增长逐渐增加,60岁以上人群,检出率为15.3%;结肠息肉大小以1cm以下最为多见,各年龄组间息肉大小差异无显著性(P>0.05);息肉的发生部位以直肠最多见(P<0.01),多部位息肉在50～79岁年龄组发生率显著高于20～49岁年龄组(P<0.01);息肉生长方式20～40岁以亚蒂为主,40岁以上无蒂息肉发生率明显高于40岁以下年龄组(P<0.01);各年龄层息肉的病理分型均以腺瘤型息肉为主(P<0.01);各年龄层均以单发息肉为主(P<0.01),随年龄增加多发息肉发生率呈上升趋势。结论结肠息肉的检出率、发生部位、生长方式、病理分型均与年龄呈一定的相关性,在行结肠镜检查和治疗时,应根据不同年龄层的息肉特点,有针对性的进行检查和治疗。

[Objective] To analyze the size, growth pattern and pathological characteristics of colorectal polyps in different age groups. [Methods] A total of 1083 patients with colorectal polyps received colonoscopy in the East Hospital from January 2009 to August 2011; The detection rate, size, location, growth pattern and pathological characteristics in different age groups were retrospectively analyzed. [Results] The polyps detection rate was increased with the age. For patients aged 60~79 years, the detection rate was 15.3%, most of the polyps size was less than 10 mm. the rectum polyps accounted for 33.5%, was more popular than other colon sections （P 0.01）. For growth pattern： non-peduncle （38.4%）, deuto-peduncle （44.1%） and peduncle （17.5%）. Of all the patients, most of the pathological type was adenomas （81.2%, P 0.01）, and other pathological types： inflammation （6.8%）, atypical hyperplasia （10.9%） and cancer （1.0%）. single polyp （61.3%） and multiple polyps is more popular in older person. [Conclusions] The incidence of colorectal polyps is especially high in patients aged more than 40 years, mainly in the rectum colon, with the common pathological types being adenomatous.