老年患者结直肠腺瘤临床及病理学特点分析

Clinical characteristics of the eldly patients with colorectal adenomas

目的了解老年患者结直肠腺瘤的临床特点,为老年结直肠癌防治提供参考。方法纳入经肠镜检查发现息肉并行病理学检查提示为结直肠腺瘤患者的老年患者共1272例,中青年患者861例,除外恶性肿瘤、家族性腺瘤性息肉病、炎症性肠病。对两组患者临床症状及结直肠腺瘤的数量、大小、发生部位、病理类型进行分析比较。结果在老年结直肠腺瘤组中,出现便秘症状的患者比例要高于非老年组结直肠腺瘤患者(31.2%比20.9%,P<0.001)。而在非老年组中,更多的患者出现腹痛和腹泻症状(45.5%比40.2%,P=0.008;36.7%比25.6%,P<0.001)。老年组患者多发腺瘤情况要多于非老年组(39.9%比31.5%,P<0.001);直径≥10 mm腺瘤的数量也多于非老年组(30.0%比14.1%,P<0.001);绒毛状腺瘤比例也高于非老年组(19.0%比16.6%,P<0.001)。结论老年患者结直肠腺瘤较中青年患者具有更高的恶变风险。

Objective To explore the clinical characteristics of the eldly patients with colorectal adenomas and provide some references for the prevention and treatment of this disease in the future. Methods The information of symptom,such as abdominal pain,diarrhea,constipation as well as position,size,number,and pathology of colorectal adenomas were detected and collected between elderly patients and middle-young aged patients.The rate of the high risk adenomas was compared between the two groups. Results The proportion of villous adenoma was higher in the elderly patients than that of the middle-young aged patients（ P〈 0.05）. Conclusion The adenomas in the elderly patients have more chance to malignant transformation than those in the young and middle-aged patients.