结直肠非肿瘤性息肉的临床病理学分析

Clinicopathological features of non-neoplastic colorectal polyps

目的探讨结直肠非肿瘤性息肉的临床病理学特点,为临床及病理诊断提供帮助。方法收集哈尔滨医科大学附属第二医院2012年1月至2016年12月肠镜及手术切除病例共1 190例,分析结直肠非肿瘤性息肉患者的临床病理学特征。结果行肠镜及手术切除1 190例中,男性746例,女性444例,男女比例为1.7∶1.0;平均发病年龄为52岁;40岁以上者1 016例(85.4%)。1 190例患者共检出1 289枚息肉,其中炎症性息肉1 238枚(96.0%),错构瘤性息肉47枚(3.7%),其他类型的息肉性病变4枚(0.3%)。1 238枚炎症性息肉中,炎性息肉1 212枚(97.9%);炎症后息肉15枚(1.2%);炎性肌腺性息肉8枚(0.6%);黏膜脱垂相关性炎症性息肉3枚(0.2%),均为深在性囊性结肠炎。47枚错构瘤性息肉中,幼年性息肉39枚(83.0%),Peutz-Jeghers息肉8枚(17.0%)。其他类型的息肉性病变的4枚息肉均为结直肠子宫内膜异位症。1 289枚息肉中,751枚息肉发生于乙状结肠和直肠(58.3%)。结论结直肠非肿瘤性息肉多见于40岁以上的患者;好发于乙状结肠和直肠;病理类型以炎症性息肉最多见,而炎症性息肉中以炎性息肉最多见;错构瘤性息肉以幼年性息肉最多见。

Objective To characterize clinicopathological characteristics of the non-neoplastic colorectal polyps for accurate diagnosis.Methods 1 190 cases were collected from the Second Affiliated Hospital of Harbin Medical University from January 2012 to December 2016 and their clinicopathological characteristics were reviewed.Results There were 746 males and 444 females patients with male/female ratio of 1.7∶1.0. The average age was 52 and 85.4% (1 016/1 190) of cases were over 40 years old. A total of 1 289 polyps were found in the study cohort including 1 238 inflammatory polyps (96.0%), 47 harmartomatous polyps (3.7%) and 4 other types of polypoid lesions (0.3%). Among 1 249 inflammatory polyps, 1 212 were inflammatory pseudopolyps (97.9%), 15 post-inflammatory polyps (1.2%), 8 inflammatory myoglandular polyps (0.6%), and 3 prolapse-type inflammatory polyps (colitis cystica profunda). Among 47 hamartomatous polyps, there were 39 juvenile polyps (83.0%), 8 Peutz-Jegher polyps (17.0%). Four polypoid lesions of endometriosis. Among 1 289 polyps, 751 polyps were located in sigmoid and rectum (58.3%). 168 polyps were pedunculated (12.9%) and 1 132 polyps were sessile (87.1%).Conclusions For non-neoplastic colorectal polyps, the average age of patients is 40 years. The polyps generally involve the sigmoid colon and rectum. The most common pathological type is inflammatory pseudopolyp and the most common pathological type of hamartomatous polyp is juvenile subtype.