结肠息肉病理分析及电切后复发情况  

Pathological analysis of colonic polyps and the recurrence of polyps after polypectomy

作　　者：王俊[1] 刘希双[1] 王光兰[1] 戴素美[1] 张黎明[2] 

机构地区：[1]青岛大学医学院附属医院消化内科,山东青岛266003 [2]山东省枣庄市立医院消化内科,山东枣庄277000

出　　处：《中国内镜杂志》2013年第6期645-648,共4页China Journal of Endoscopy

摘　　要：目的分析结肠息肉的内镜特征及癌变情况,比较息肉电切前后的组织病理学结果,了解息肉切除后再发情况及影响因素,指导内镜治疗及随访。方法分析总结2009年12月13日～2010年12月12日该院接受肠镜检查的结肠息肉患者的内镜特征,分析影响息肉恶变的因素;对比行内镜下息肉切除的患者电切前后的组织病理学结果;统计电切后息肉再发率,分析影响再发的因素。结果息肉患者共1401例,检出息肉3955颗,年龄>50岁、左半结肠息肉、直径>1.0cm、广基及分叶状息肉容易癌变(P<0.05);息肉电切前后的病理学结果不符合的概率为33.7%;电切后息肉再发率为56.7%,38.1%于1年内再发,78.2%于2年内再发;多发性息肉、年龄大于50岁、息肉直径>1.0cm及腺瘤性息肉更容易再发(P<0.01)。结论结肠息肉电切前后的病理学结果存在较大差异,活检可能漏诊癌变息肉;息肉电切后再发率高,应定期进行复查。【Objective】To guide endoscope treatment and prognosis judgment, investigate the endoscopic characteristics of colonic polyps and cancerous polyps, analyze the recurrence of polyps after polypectomy and its influencing factors for comparison of pathological status of colonic polyps between before and after polypectomy. 【Methods】The endoscopic characteristics of colonic polyps which have accepted endoscopy from December 13th, 2009 to December 12th, 2010 were analyzed, and pathological diagnosis before and after polypectomy were compared. The recurrence rate of polyps after polypectomy was calculated and its affect factors were analyzed.【Results】 1401 patients with 3955 colonic polypus had received endoscopy in our hospital. The polyps in left hemicolon, the polyps diameter1.0 cm, the sessile and lobulated polyps was easy to cancerate （P 0.05）. Pathological inconsistency was 33.7% between biopsy and polypectomy. The recurrence rate of polyps after polypectomy was 56.7% , 38.1% polyps recurred within 1 year and 78.2% polyps recurred within 2 years. Multiple polyps that were older than 50 years, the polyps diameters were bigger than 1.0cm and the adenomatous polyps were apt to recur （P 0.01）.【Conclusion】Pathological difference exists significantly between before and after polypectomy, biopsy may miss malignant polyps. The recurrence of polyps is so high that the patients need intense follow-up.

关 键 词：结肠息肉 结肠镜 病理 切除术 复发 

分 类 号：R574.6[医药卫生—消化系统]