锯齿状腺瘤伴有不同上皮内瘤变相关风险因素分析

Analysis of risk factors related to serrated adenoma with different intraepithelial neoplasias

目的探讨无蒂锯齿状腺瘤(sessile serrated adenomas,SSA)与传统锯齿状腺瘤(traditional serrated adenomas,TSA)病变特征与上皮内瘤变及发展为结直肠癌(colorectal cancer,CRC)之间的关联。方法收集2020年1月至2021年12月于新疆医科大学第一附属医院住院患者中病理诊断为SSA和TSA的患者,对一般临床资料、病变内镜特征及病理特征进行回顾性研究。结果不同上皮内瘤变在患者年龄病变直径、病变分布部位、病变带蒂特征、病变形状特征间比较,差异有统计学意义(P<0.05)。TSA的上皮内瘤变或癌变率高于SSA(χ^(2)=6.44,P=0.011)。结论大锯齿状腺瘤的存在增加CRC风险,尤其是年龄较大以及病变为长蒂型或亚蒂型的患者。TSA较SSA更易伴有上皮内瘤变或发展为CRC。

Objective To explore the relationship between the pathological features of sessile serrated adenomas(SSA)and traditional serrated adenomas(TSA),intraepithelial neoplasia and colorectal cancer(CRC)ulteriorly.Methods Collecting the general clinical data of patients with SSA and TSA diagnosed pathologically in the First Affiliated Hospital of Xinjiang Medical University from Jan.2020 to Dec.2021,and retrospectively studing the endoscopic and pathological characteristics of the lesions.Results There was statistical difference among different intraepithelial neoplasias in age,adenoma diameter,lesion site,pedicled characteristics of lesions and shape characteristics of lesions(P<0.05).The rate of intraepithelial neoplasia or canceration of TSA was higher than that of SSA(χ^(2)=6.44,P=0.011).Conclusion The presence of large serrated adenoma increases the risk of CRC,especially in older patients and those with long pedicle or sub pedicle lesions.TSA is more likely to be accompanied by intraepithelial neoplasia or develop into CRC than SSA.