不同年龄段结直肠息肉的内镜表现与病理特征比较

Comparisn of endoscopic and pathological features of colorectal polyps in different age groups

目的分析总结不同年龄段患者结直肠息肉的内镜表现与病理特征。方法选择我院31～75岁接受结肠镜检查的4 981例门诊及住院患者,对不同年龄段患者结直肠息肉的内镜检出率、大小、形态、病理类型、分布部位进行对比分析。结果随着年龄的增长,结直肠息肉检出率呈递增趋势(P<0.05)。各组检出结直肠息肉均以直径<10 mm为主,但随年龄增加直径≥10 mm结直肠息肉比例有所升高,其中61～75岁组最高,且其明显高于31～40岁组(P<0.05)。结直肠息肉分布部位以乙状结肠、直肠为主,各组间结直肠息肉分布位置比较,差异无统计学意义(P>0.05)。各组均以管状腺瘤为主要病理类型,随着年龄的增加,管状-绒毛状腺瘤/绒毛状腺瘤/上皮内瘤变/局部癌变比例有上升的趋势,其中61～75岁组比例明显高于31～40岁组(P<0.05)。结论结直肠息肉临床特征与年龄密切相关,临床上应结合不同年龄段的临床特征制定筛查方案。

Objective To analyzed and summarized endoscopic and pathological features of colorectal polyps in different age groups. Methods A total of 4 981 outpatients and inpatients aged 31-75 who underwent colonoscopy in our hospital were selected. The endoscopic detection rate, size, shape, pathological type and distribution of colorectal polyps were compared and analyzed in different age groups. Results With the increase of age, the detection rate of colorectal polyps increased(P<0.05).Colorectal polyps with diameter <10 mm were mainly detected in all groups, but with the increase of age, the proportion of colorectal polyps with diameter ≥10 mm increased, which in 61-75 years old group was the highest, and which was significantly higher than that in the 31-40 years old group(P<0.05). The distribution of colorectal polyps was mainly sigmoid colon and rectum. There was no significant difference in the distribution of colorectal polyps between the groups(P >0.05). Tubular adenoma was the main pathological type in all groups. With the increase of age, the proportion of tubular-villous adenoma/villous adenoma/intraepithelial neoplasia/local canceration increased, which in the 61-75 years old group was significantly higher than that in the 31-40 years old group(P<0.05). Conclusion The clinical characteristics of colorectal polyps are closely related to age. Screening programs should be formulated according to the clinical characteristics of different age.