结直肠癌患者伴发结直肠息肉的临床特点

Clinical characteristics of adenomatous polyps in colorectal cancer

目的:探讨结直肠癌(colorectal cancer,CRC)患者结直肠息肉的形态学及病理学特点.方法:对2009-04/2012-08于扬州市第一人民医院西区行结肠镜检查的患者进行回顾性分析.将患者分为两组:CRC组与非CRC组.统计患者的性别、年龄、息肉检出情况(部位、数量、大小及病理学特点)以及CRC检出情况,对比分析两组患者息肉形态学及病理学特点.结果:共纳入3022例患者,CRC组142例(4.7%),非CRC组2880例.CRC组息肉、多发性息肉及高危腺瘤检出率较非CRC组均显著增加(P=0.017、0.02、0.002);CRC组患者管状腺瘤和绒毛状腺瘤检出率均高于非CRC组(P<0.05),但两组在病变的大小、病理类型等方面差异无统计学意义(P>0.05);CRC组右半结肠病变比例较非CRC组高(37.4%vs 27.5%,P=0.007),有统计学意义.结论:CRC患者息肉及高危腺瘤检出率明显高于非CRC患者,临床工作中应重视并提高CRC患者及CRC术后患者全结肠镜检查质量.

AIM： To evaluate the morphological and pathologic features of polyps in colorectal cancer （CRC） patients. METHODS： A total of 3166 patients underwent colonoscopy between April 2009 and August 2012 at the First People’s Hospital of Yangzhou. These patients were divided into two groups： CRC and non-CRC. Sex, age, characteristics of adenomatous polyps （location, number, size, morphology and pathology）, and CRC were recorded. The morphological and pathologic features of polyps in the two groups were analyzed. RESULTS： Of 3022 cases who underwent total colonoscopy, 142 were diagnosed with CRC （4.7%）, and 2880 had non-CRC diseases. CRC patients had higher prevalences of polyps, multiple polyps and high-risk adenomas than non-CRC patients （P = 0.017, 0.02, 0.002）. Although CRC patients had a higher frequency of tubular or villous adenomas （P 〈 0.05）, no significant differences in size of the lesion or pathological type were observed between the two groups. The frequency of right colonic lesions in CRC patients was significantly higher than that in non-CRC patients （37.4% vs 27.5%, P = 0.007）. CONCLUSION： There are high detection rates of colon polyps and high-risk adenomas in CRC patients. The quality of colonoscopy should be stressed in CRC patients.