1080例肠黏膜活检的病理分析

Pathological analysis of intestinal mucosa biopsy in 1080 cases

目的对行肠镜下送检肠黏膜活检的病理结果进行分析,为促进肠镜检查提供临床帮助。方法回顾性分析天津市第一中心医院2017年11月—2020年11月收治的1080例患者肠黏膜活检的病理结果,基于性别,年龄,好发部位和组织学类型进行分析,总结其临床特征及规律。结果女性肠黏膜慢性炎症发生率为35.66%,高于男性的29.74%;20~40岁肠黏膜活检慢性炎症的发生率为55.49%,高于>40~60岁、>60岁的29.68%、25.59%;20~40岁腺瘤发生率为19.23%,明显低于>40~60岁、>60岁的36.02%、32.30%;>60岁结直肠癌发生率为19.24%,高于>40~60岁、20~40岁的4.95%、9.80%;20~40岁直肠发生率为34.07%,明显高于>40~60岁、>60岁的25.07和24.86%,>60岁升结肠发生率为14.16%,高于20~40岁的7.14,差异均有统计学意义(P<0.05)。病变部位的数量最多为直肠,然后依次为乙状结肠,横结肠(肝曲),升结肠,降结肠,结肠发生回盲部,结肠脾曲。直肠癌中的中分化腺癌占比为63.16%,明显高于本组中的其他组织学分型,差异均有统计学意义(P<0.05)。结论结肠镜黏膜活检的病理结果可鉴别良性与恶性,患者年龄越大,结直肠癌的发生率越高,因此需要早预防早治疗。

Objective To analyze the pathological results of intestinal mucosal biopsy under colonoscopy,in order to provide clinical assistance for promoting colonoscopy examination.Methods A retrospective analysis was conducted on the pathological results of intestinal mucosal biopsies of 1080 patients admitted to Tianjin First Central Hospital from November 2017 to November 2020,based on gender,age,common site and histological type,to summarize their clinical characteristics and patterns.Results The incidence of chronic inflammation of the intestinal mucosa in females was 35.66%,which was higher than 29.74%in males;the incidence of chronic inflammation in intestinal mucosal biopsy in the ages of 20 to 40 years old was 55.49%,which was higher than that of 29.68%and 25.59%in the ages of over 40 to 60 and over 60 years old;the incidence of adenomas in the ages of 20 to 40 years old was 19.23%,which was significantly lower than the 36.02%and 32.30%in the ages of over 40 to 60 and over 60 years old;the incidence of colorectal cancer in the ages of over 60 years old was 19.24%,which was higher than the 4.95%and 9.80%in the ages of 20 to 40 and over 60 years old.The incidence of rectal cancer in the ages of 20 to 40 years old was 34.07%,which was significantly higher than the 25.07%and 24.86%in the ages of over 40 to 60 and over 60 years old,respectively;the incidence of ascending colon in those over 60 years old was 14.16%,which was higher than the 7.14%in the ages of 20 to 40 years old,and the differences are statistically significant(P<0.05).The number of location of lesions was highest in the rectum,followed by the sigmoid colon,transverse colon(hepatic flexure),ascending colon,descending colon,colon often returning to the blind,and colon splenic flexure.The proportion of moderately differentiated adenocarcinoma in rectal cancer was 63.16%,which was significantly higher than other histological subtypes in this group,and the differences were statistically significant(P<0.05).Conclusion The pathological results of colonoscopy mucosal biopsy could differentiate enign from ma ligna nt.The older the pa tient wa s,the higher the incidence ra te of colorecta l ca ncer wa s.Therefore,ea rly prevention a nd ea rly trea tment were needed.