大肠黏膜白斑10例临床分析

Clinical analysis of 10 cases of large intestine white spot

目的 了解大肠黏膜增生病变周围白斑的临床特征,探讨其临床及组织病理意义。方法 收集于2018年1月至2019年1月在我科接受内镜治疗的1 487例大肠黏膜增生病变患者的临床资料,回顾性分析大肠黏膜增生病变周围黏膜出现白斑病例的临床资料。结果 接受内镜治疗的大肠黏膜增生病变患者白斑发生率为0.67%(10/1 487),年龄47~66岁,中位年龄59岁;男6例,女4例;病变面积0.4 cm×0.6 cm至3.0 cm×3.2 cm,中位数3.13 cm^2;发生部位:直肠4例,乙状结肠6例;内镜下黏膜切除术(endoscopic mucosa resection,EMR)切除4例,经内镜黏膜下剥离术(endoscopic submucosal dissection,ESD)切除5例,未治疗1例。腺瘤癌变4例,绒毛状腺瘤1例,腺瘤伴低级别瘤变4例。结论 大肠黏膜白斑常出现在肿瘤性病变周围,癌性病变率较高。它可能是大肠恶性肿瘤的标志之一。

Objective To investigate the clinical features and pathological significance of white spots of colonic mucosa hyperplasia.Methods Counted 10 cases with white spots around the lesion from 1 487 cases of colon mucosal hyperplasia treated by endoscopy,in the department of gastroenterology,the second affiliated hospital of Xi’an Jiaotong university from January 2018 to January 2019,and analyzed the clinical significance of the white spots.Results The incidence of white spots was 0.67%of endoscopically-treated lesions.Age ranging from 47 to 66 years old,with a median age 59 years old.There were 6 males and 4 females.The maximum diameter of the lesion was 0.6~3.2 cm,with median of 3.13 cm^2.Lesion located rectum were 4 cases,sigmoid colon 6 cases,resected by EMR were 4 cases,ESD 5 cases,and no treatment in 1 case.There were 4 cases of mucosal carcinogenesis,1 case of villous adenoma,and 4 cases of adenoma with low-grade neoplasia.Conclusion Colonic white spots appear around the neoplastic lesion and have a high rate of canceration,which may be one of the markers of colonic malignancy.