不同年龄段结肠息肉患者的内镜检查结果及病理特征分析

Endoscopic examination and pathological features of patients with colonic polyps in different ages

目的:分析不同年龄段结肠息肉患者的内镜检查结果和病理特征。方法:选择我院2015-08~2017-02行电子结肠镜检查存在结肠息肉的患者500例为研究对象,依据年龄分为20~29岁组、30~39岁组、40~49岁组、50~59岁组、60~69岁组、≥70岁组。分析不同年龄组患者结肠息肉检出率、病理类型、山田分型、大小和发生部位等特点。结果:本研究中共2 242例患者行电子结肠镜检查和病理组织学检查,500例患者存在结肠息肉,检出率为22.30%;伴随年龄的增长,结肠息肉的检出率逐渐升高。不同年龄组患者结肠息肉病理分型主要为腺瘤型息肉,且伴随年龄的增长,腺瘤型息肉所占比例逐渐提高;癌症检出率比较,差异不显著(P>0.05)。结肠息肉山田分型主要为Ⅰ型,其中>60岁组山田Ⅰ型检出率高于20~59岁组,山田Ⅲ型检出率低于20~59岁组,差异有统计学意义(P<0.05)。结肠息肉直径主要为<0.5cm,其次为0.5~1.0cm,不同年龄组间结肠息肉直径比较,差异不显著(P>0.05)。结肠息肉发生部位主要为直肠,伴随年龄的增长,直肠部位和多部位息肉检出率均逐渐增长,其中>50岁组多部位息肉检出率高于20~49岁组,差异有统计学意义(P<0.05)。结论:结肠息肉的检出率、病理分型、山田分型、发生部位与年龄均存在显著相关性,结肠息肉的癌变风险、大小与年龄无明显相关,临床应根据不同年龄段结肠息肉的病理特点采取针对性诊疗措施。

Objective.. To analyze the endoscopic examination and pathologic features of colonic polyps in different age groups. Methods.. A total of 500 patients with colonic polyps were enrolled in this study from August 2015 to February 2017.All patients were divided into 20--29 years old group,30--39 years old group,40--49 years old group,50--59 years old group,60- 69 years old group,70 years old group. The detection rate of colonic polyps in different age groups, pathological type of colonic polyps, Yamagata type, size and occurrence site were compared. Results. A total of 2 242 patients underwent endoscopic ultrasonography and histopathological examination.The detection rate of colonic polyps was found to be 22.30~ in 500 patients. The detection rate of colonic polyps was gradually increased with age. The pathologieal types of colonic polyps in different age groups were mainly adenomatous polyps,and with the increase of age,the proportion of adenoma polyps gradually increased.There was no significant difference in the detection rate of cancer among different age groups （P 〉0.05）. The detection rate of type [ was higher than that of 20--59 years old group,and the detection rate of type Ⅲ was lower than that of 20--59 years old group,the difference was statistically significant （P〈0.05）.The size of colonic polyps in different age groups was mainly 〈0.5 cm, followed by 0.5--1.0 cm.There was no significant difference in colonic polyps between different age groups （P〉0.05）.The incidence of colorectal polyps in different age groups was mainly rectum, and the detection rate of rectal parts and polyps was gradually increased with age. The detection rate of polyps was higher in 〉50 years old group than that in 20--49 years old group, the differences were statistically significant （P 〈 0.05）. Conclusion ： The detection rate, pathological type, classification and occurrence of colonic polyps are significantly correlated with age.The risk of colorectal polyps has no obvious correlation with age.Specific diagnosis and treatment measures should be taken according to clinical characteristics of colorectal polyps in different ages.