大肠腺瘤恶变的相关因素探讨

Analysis of the relevant factors of malignant change of colorectal adenoma

目的 探讨大肠腺瘤恶变的相关因素。方法 回顾性分析 14年间 2 76例大肠腺瘤的临床资料。结果 左半结肠腺瘤癌变率高于右半结肠 (P <0 .0 5 ) ;大于 2cm腺瘤癌变率高于小于 2cm者 (P <0 .0 1) ;绒毛状腺瘤癌变率高于管状和混合性腺瘤 (P <0 .0 1) ;重度不典型增生腺瘤的癌变率明显高于轻度、中度不典型增生 (P <0 .0 1) ;多发腺瘤癌变率高于单发 (P <0 .0 5 ) ;腺瘤表面炎症重、糜烂、分叶、无蒂者癌变率高于表面光滑 ,长蒂者 (P <0 .0 1)。结论 腺瘤的组织学类型、不典型增生程度以及肿瘤大小、数目、部位、年龄等诸多因素是腺瘤恶变相关的危险因素。

Objective To study the relevant factors of malignant change of colorectal adenoma. Methods The clinical data of 276 cases of colorectal adenoma admitted in our hospital in recent 14 years were analyzed retrospectively . Results Malignant change rate of the adenoma in the left colon was significantly higher than that in right colon(P<0.05);in the diameter of adenoma more than 2 cm was significantly higer than that in less than 1 cm( P<0.01);in villous adenoma was significantly higher than that in tubiform adenoma and mixed adenoma(P<0.01);in severe atypical hyperplastic adenoma was significantly higher than that in mild and moderate atypical hyperplatic adenoma(P<0.01);in multiple adenoma was significantly higher than that in single adenoma(P<0.05);in erosion and sessile adenoma were significantly higher than that in smooth and pedicle adenoma (P<0.01).Conclusions The histological type, degree of atypical hyperplasia, the size, number, location of the adenoma and the patients age are the relevant risk factors of malignant chang factors of colonic adenoma.