内镜诊治大肠息肉2000例临床病理分析  

The clinical pathological features of colorectal polyps by colonoscope management in 2000 cases.

作　　者：张斌[1] 郑玉贵[1] 张德恒[1] 

机构地区：[1]白求恩医科大学第三临床学院,长春130031

出　　处：《中国实用外科杂志》1999年第11期661-662,共2页Chinese Journal of Practical Surgery

摘　　要：目的　探讨大肠息肉的分布、大小、组织形态学特征与息肉癌变的关系。方法　回顾性分析经内镜诊治的２０００ 例良、恶性息肉的内镜、病理与临床资料。结果　共诊治息肉２０００ 例，２８９６ 枚，息肉恶变１０３ 例。左半结肠２２１２ 例，占总数８２－５ ％ ，癌变息肉８５ 例，占癌变总数８２％ ．宽基息肉癌变率高，与亚蒂、短蒂、长蒂息肉相比差异有统计学意义。直径大于２－０ｃｍ 的息肉癌变率１５－７ ％ ，１ ～２ｃｍ 为２－８１ ％ 。绒毛状腺瘤癌变率２１－２９ ％ ，管状腺瘤１－０３ ％ ，混合状腺瘤９－５２ ％ 。结论　远端大肠息肉、宽基息肉、直径大于２－０ｃｍ 息肉、绒毛状腺瘤易恶变。发现大肠息肉，不论大小，尽量内镜治疗，全瘤送检。内镜切除息肉是防治大肠癌的最有效的手段之一。Objective The relationship between location,size,morphology and histopathology of colorectal polyps was investigated.Methods A number of 2000 patients with benign and malignant colorectal polyps was retrospectively reviewed with endoscopy features and pathological characters.Results 2896 polyps in 2000 patient were managed by colonoscopy,it included 103 malignant polyps.2212(82 5%)polyps located left colon;malignant polyps in left colon were 85(82%).The rate of malignant change from the benign in large peduncle polyps was significantly higher than midi,short and long peduncle polyps.The rates of malignant change from the benign in diameter over 2 0cm and between 1-2 0cm polyps were respectively 15 7% and 2 81%。And malignant change rates were 21 29% in villous polyps,1 03% in tubular polyps,and 9 52% in mixed polyps.Conclusion The left colon polyps,large peduncle polyps,>2 0cm in diameter polyps and villous polyps were easily malignant change.If colorectal polyps were found,endoscopy management should be done as early as possible.It is one of the best method to remove colorectal polyps by endoscopy.

关 键 词：大肠息肉 息肉癌变 内窥镜 诊断 治疗 

分 类 号：R735.34[医药卫生—肿瘤] R730.269[医药卫生—临床医学]