不同年龄段结直肠息肉患者临床特点及病理对比分析

Analysis clinical characteristics and pathology of colorectal polyps in various age groups

目的探讨不同年龄人群结直肠息肉发病特点,为肠道肿瘤的早期筛查提供临床依据。方法回顾性分析河北医科大学第一医院2022年4月—2023年3月收治的571例结直肠息肉患者临床资料,按照不同年龄分为青年组75例(≤44岁)、中年组256例(45~59岁)和老年组240例(≥60岁),采用χ^(2)检验分析3组患者结直肠息肉的生物学特性。结果青、中年组男性患者多见,老年组女性患者多见(P<0.001)。3组间比较,升结肠息肉发生率在老年组中最高(P=0.002),直肠息肉发生率在青年组中最高(P=0.001),但老年组直肠肿瘤性息肉发生率显著高于中、青年组[64.7%(139/215)vs.34.9%(60/172)vs.21.2%(14/66),P<0.001]。多发息肉、≥1.0 cm息肉、管状腺瘤的发生率均在老年组中最高(P<0.05),但各年龄组间不同病理类型息肉中息肉的长径大小差异均无统计学意义(P>0.05)。长径≤0.5 cm和0.6~0.9 cm的息肉中管状腺瘤发生率均在老年组中最高(P<0.001),增生性息肉发生率在老年组中最低(P<0.001),但长径≥1.0 cm息肉的病理类型在各年龄组间差异无统计学意义,均以管状腺瘤多见(P>0.05)。结论不同年龄人群中结直肠息肉的生物学特性不同,伴随年龄的增长,结直肠息肉的好发人群、生长部位、息肉大小、息肉数量及病理类型呈现一定的趋势变化。

Objective This study aims to investigate the characteristics of colorectal polyps in different age populations,providing a clinical foundation for early screening of intestinal tumors.Methods We conducted a retrospective analysis of clinical data from 571 patients with colorectal polyps at the First Hospital of Hebei Medical University,covering the period from April 2022 to March 2023.These patients were divided into three groups based on age:young group(75 patients,≤44 years old),middle-aged group(256 patients,45-59 years old),and elderly group(240 patients,≥60 years old).The biological characteristics of colorectal polyps in each group were analyzed using the Chi-squared test.Results Male patients were more common in the young and middle-aged groups,whereas female patients were more prevalent in the elderly group(P<0.001).Comparing the three groups,the incidence of polyps in the ascending colon was highest in elderly group(P=0.002),and the incidence of rectal polyps was highest in young group(P=0.001).Notably,the elderly group exhibited a significantly higher incidence of neoplastic rectal polyps compared to the middleaged and young group[64.7%(139/215)vs.34.9%(60/172)vs.21.2%(14/66),P<0.001].Additionally,the incidence of multiple polyps,polyps with a size≥1.0 cm,and tubular adenomas were highest in elderly group(P<0.05),while there was no significant difference in the lengths among different pathological types of polyps(P>0.05).The incidence of tubular adenomas in polyps with≤0.5 cm and 0.6-0.9 cm were highest in elderly group(P<0.001),while the incidence of hyperplastic polyps was lowest in elderly group(P<0.001).However,there was no significant difference in the pathological types of polyps with a size≥1.0 cm among the three groups,with tubular adenomas being the most common for this size polyps(P>0.05).Conclusion The biological characteristics of colorectal polyps exhibit variations across different age groups,including changes in the risk population,growth position,size,number,and pathological types,which tend to follow a discernible trend with increasing age.