740例结直肠息肉内镜、病理表现和临床特征分析

Endoscopic Findings,Pathology and Clinical Features of Colorectal Polyps: Analysis of 740 Cases

背景:近年随着生活方式和环境的改变,结直肠癌的发病率逐年上升。结直肠息肉是结直肠癌重要的癌前病变,内镜下早发现、早诊断对防治结直肠癌具有重要意义。目的:探讨结直肠息肉内镜、病理表现和临床特征。方法:纳入2014年1月—2016年6月深圳市第三人民医院的结直肠息肉患者,并对患者的一般资料、内镜下表现、病理类型和癌变情况进行回顾性分析。结果:共检出740例结直肠息肉患者,男女之比为1.75∶1,年龄>40岁者559例(75.5%)。70.4%的息肉位于左半结肠,病理类型以炎性息肉(29.0%)、增生性息肉(29.6%)和管状腺瘤(30.3%)为主。38例息肉患者发生癌变,癌变率为5.1%,癌变息肉的类型为管状腺瘤、管状绒毛状腺瘤和绒毛状腺瘤;多数(87.2%)癌变息肉直径>1.5 cm,多数(76.9%)癌变息肉位于左半结肠。结论:性别、年龄、病理类型、直径可能对息肉癌变有影响,应高度重视年龄>40岁、男性、息肉直径>1.5 cm以及病理类型为管状绒毛状腺瘤和绒毛状腺瘤的息肉患者并进行随访。

Background： In recent years,with the change of lifestyle and environment,the incidence of colorectal cancer is increasing. Colorectal polyp is an important precancerous lesion of colorectal cancer; endoscopic early detection,early diagnosis are important for the prevention and treatment of colorectal cancer. Aims： To investigate the endoscopic findings,pathology and clinical features of colorectal polyps. Methods： Patients with colorectal polyps from January 2014 to June2016 at the Third People＇s Hospital of Shenzhen were enrolled,and the general information data,endoscopic findings,pathology and canceration rate were retrospectively analyzed. Results： A total of 740 patients had colorectal polyps detected,the ratio of male to female was 1. 75 ∶ 1,559（ 75. 5%） patients were aged 〉40 years,70. 4% of polyps were located in left hemicolon,the main pathological type of polyps were inflammatory polyps（ 29. 0%）,hyperplastic polyps（ 29. 6%）,tubular adenoma（ 30. 3%）. Cancer was found in 38 patients,canceration rate was 5. 1%; the main pathological types of cancerated adenoma were tubular adenoma,tubular villous adenoma and villous adenoma,and 87. 2% had a diameter greater than 1. 5 cm,and were mainly located in left hemicolon（ 76. 9%）. Conclusions： Gender,age,pathological type,diameter of colorectal polyps are important factors of canceration. Male colorectal polyps patients with age 〉40 years,diameter greater than 1. 5 cm,tubular villous adenoma and villous adenoma should be paid attention and followed up.