大肠息肉的异型增生及恶变

Heteromorphous Hyperplasia and Malignant Change of Colorectal Polyps

目的 :研究息肉间变的相关因素。方法 :总结 449个息肉及其中伴异型增生或恶变息肉的分布、大小及病理资料。结果 :449个息肉异型增生达 2 0 .3 % ,息肉恶变 6.5 % ,好发于直肠及乙状结肠。异型增生及恶变息肉随息肉增大而增加 ,息肉恶变率直径 0 .6～ 1.0cm者为 1.6% ,1.1～ 1.9cm者为 8.5 % ,≥ 2 .0cm者为 2 4.1%。腺瘤性息肉异型增生及恶变率明显高于非腺瘤性息肉 ,其异型增生为 3 1.9% ,恶变率为 10 .9% ,非腺瘤性息肉异型增生为 4.6% ,恶变仅 1个。其中腺瘤中又以绒毛状腺瘤及绒毛管状腺瘤异型增生及癌变最多见 ,无蒂息肉恶变率高。结论 :息肉间变与息肉的大小、形态和类型有密切关系 ,不管何种类型及大小的息肉均应作完整切除。

Objective To study the correlation of benign,heteromorphous hyperplasia and malignant polyps with size,morphology and pathology.Method Data of 449 cases were summarized and analysed.Results The incidence of heteromorphous hyperplasia and malignant change were 20.3% and 6.5% respectively.They were found mainly in rectum and sigmoid.The rates of malignant changes were 1.6%,8.5% and 24.1% for 0.6～1.0?cm,1.1～1.9?cm and 2.0?cm in diamenter.The incidence rates of heteromorphous hyperplasia and malignant change of adenoma were 31.9% and 10.9% respectively.In non adenoma,the rate of heteromorphous hyperplasia was 4.6%.Most of heteromorphous hyperplasia and malignant polyps were villous and tubulovillous adenoma.Conclusion The incidence rates of the malignant polyps and heteromorphous hyperplasia polyps were closely related with their size,morphology and type.Any polyps is to be resected regardless its type and size.