结肠息肉1239例内镜及病理分析  

Endoscopic and pathologic analysis of colorectal polyps:a report of 1239 cases

作　　者：李鹃[1] 岳文杰[1] 刘懿[1] 董乐[1] 张志军[1] 王磊[1] 刘杰[1] 

机构地区：[1]复旦大学附属华山医院消化科,上海200040

出　　处：《上海医学》2010年第6期585-588,共4页Shanghai Medical Journal

摘　　要：目的探讨结肠息肉的大小、生长方式及病理分型等生物学特性与年龄的关系。方法回顾性分析复旦大学附属华山医院2003年1月—2008年10月经电子结肠镜检出的1 239例结肠息肉的大小、部位、生长方式及病理分型等在各年龄层的分布情况。结果①结肠息肉的大小、发生部位、生长方式、病理分型、单发或多发在各年龄层中的差异均有统计学意义（P值均〈0.05）。②40~79岁年龄段中,直径≤5 mm的息肉占53.0%,左半结肠息肉占51.3%,腺瘤型息肉占44.8%,单发息肉占55.4%。③左半结肠的息肉占59.1%,右半结肠的息肉占20.3%,全结肠的息肉占20.7%。④无蒂息肉占70.6%,亚蒂息肉占13.7%,有蒂息肉占15.7%;单发息肉占64.2%,多发息肉占35.8%。⑤腺瘤性息肉占51.1%,炎性息肉占35.1%,不典型增生息肉占10.7%,增生性息肉占2.3%,癌性息肉占0.8%。⑥不同大小结肠息肉的病理分型的差异有统计学意义（χ2=98.78,P〈0.0001）。不同性别间结肠息肉大小的差异无统计学意义（χ2=3.24,P=0.52）。结论 40-79岁年龄段好发结肠息肉。结肠息肉好发于左半结肠,病理类型以腺瘤性息肉和炎性息肉多见。结肠息肉大小与性别之无关。随着息肉逐渐增大,癌变的可能性也呈上升趋势。Objective To analyze the size,growth pattern and pathological characteristics of colorectal polyps and their relationship with patients＇age.Methods A total of 1 239 patients with colorectal polyps received colonoscopy in our hospital from January 2003 to October 2008;and their clinical data including the size,location,growth pattern and pathological characteristics in different age groups were retrospectively analyzed.Results The size,number,location,growth pattern and pathological characteristics of colorectal polyps were significantly different between different age groups（P0.05）.For patients aged 40-79 years,those with size less than 5mm accounted for 50.3%,the left colon polyps accounted for 51.3%,adenomatous polyps accounted for 4.8%,and single polyp accounted for 55.4%.For location of the polyps： the left colon（59.1%）,the right colon（20.3%） and the whole colon（20.7%）.For growth pattern： non-peduncle（70.6%）,deuto-peduncle（13.7%） and peduncle（15.7%）,single polyp（64.2%） and multiple polyps（35.8%）.For pathological types：adenomas（51.1%）,inflammation（35.1%）,atypical hyperplasia（10.7%）,hyperplasia（2.3%）and cancer（0.8%）.There were significant differences between pathological characteristics and sizes of colorectal polyps（χ2=98.78,P0.000 1）.And there were no significant difference in the sizes of polyps of patients with different sexes（χ2=3.24,P=0.52）.Conclusion The incidence of colorectal polyps is especially high in patients aged 40-79 years,mainly in the left colon,with the common pathological types being adenomatous and inflammatory polyps.Gender has no obvious influence on the sizes of colorectal polyps.The larger the diameters of polyps,the higher the chance for malignant transformation of the polyps.（Shanghai Med J,2010,33： 585-588）

关 键 词：结肠息肉 结肠镜检查 发生率 癌变 

分 类 号：R656.9[医药卫生—外科学]