不同分度大肠黑变病伴发息肉的内镜特点分析

Endoscopic characteristics of different grades of melanosis coli complicated with polyps

目的探讨不同分度大肠黑变病(MC)伴发息肉的内镜特点。方法回顾性分析597例行结肠镜检查并诊断为MC患者的临床资料及内镜资料。分析不同分度MC与年龄、性别、伴发肠道疾病的相关性。并将不同分度MC合并息肉患者的性别、年龄、息肉大小、息肉病理类型等进行统计学分析。结果Ⅰ度MC比Ⅱ、Ⅲ度MC更易检出合并息肉。不同分度MC合并息肉大小比较有统计学意义,其中<0.5 cm息肉在Ⅲ度MC合并息肉组检出率(37.5%)低于Ⅰ度MC合并息肉组(67.11%)组和Ⅱ度MC合并息肉组(60.18%);0.6~1.0 cm息肉在Ⅲ度MC合并息肉组检出率(57.50%)高于Ⅰ度MC合并息肉组(23.49%)组和Ⅱ度MC合并息肉组(25.66%)。增生性息肉、管状腺瘤在不同分度MC合并息肉患者的分布比较差异有统计学意义(P均<0.05);炎性息肉、潴留性息肉、锯齿状腺瘤、管状-锯齿状腺瘤在不同分度MC合并息肉患者的分布比较差异无统计学意义(P均>0.05)。结论Ⅰ度MC更易检出息肉,Ⅲ度MC更易检出0.6~1.0 cm息肉,Ⅰ度MC更易检出增生性息肉,而Ⅱ、Ⅲ度MC更易检出管状腺瘤。

Objective To investigate the endoscopic characteristics of different grades of melanosis coli(MC)complicated with polyps.Methods Clinical and endoscopic data of 597 patients diagnosed with MC who underwent colonoscopy were retrospectively analyzed.The correlation of different grades of MC with age,gender and intestinal diseases was analyzed.The gender,age,polyp size and pathological type of polyps in patients with different grades of MC were analyzed statistically.Results Polyps were more commonly detected in gradeⅠMC than in gradeⅡand gradeⅢMC.The size of polyps significantly differed among different grades of MC.The detection rate of<0.5 cm polyps in gradeⅢMC was 37.50%,significantly lower than 67.11%in gradeⅠand 60.18%in gradeⅡMC.The detection rate of 0.6-1.0 cm polyps in gradeⅢMC was 57.50%,significantly higher than 23.49%in gradeⅠand 25.66%in gradeⅡMC.The detection rates of hyperplastic polyps and tubular adenoma significantly differed among different grades of MC complicated with polyp(all P<0.05).No statistical significance was observed in the distribution of inflammatory polyp,retention polyp,serrated adenoma and tubular-serrated adenoma among different grades of MC complicated with polyp(all P>0.05).Conclusions Polyps are more commonly detected in gradeⅠMC.Polyps of 0.6-1.0 cm in size are more likely to be detected in gradeⅢMC.Hyperplastic polyps are more commonly detected in gradeⅠMC,whereas tubular adenoma in gradeⅡandⅢMC.