结肠息肉癌变的相关危险因素及内镜治疗随访结果分析  

Analysis of the risk factors and the effect of endoscopy for the colorectal polyp cancerization

作　　者：舒晴[1] 赵素芳[1] 焦璐[1] 郭海建[1] 刘俊[1] 

机构地区：[1]深圳市第二人民医院消化科,518000

出　　处：《现代消化及介入诊疗》2016年第1期24-27,共4页Modern Interventional Diagnosis and Treatment in Gastroenterology

摘　　要：目的探讨大肠息肉癌变的相关危险因素及内镜下手术方式对复发率的影响。方法收集我院2012年1月至2015年6月行结肠镜检查的患者资料,对于经病理证实为大肠息肉并上皮内瘤变的患者一般情况、内镜下息肉性状、不同内镜治疗方法的选择及术后随访进行回顾性分析。结果在我院进行结肠息肉内镜治疗患者中,发现息肉合并上皮内瘤变的共91例。其中合并高级别上皮内瘤变44例,合并中低级别上皮内瘤变47例,两组性别、年龄、便血、吸烟史、息肉数、息肉大小及pit pattern分型比较,差异有统计学意义(P均<0.05)。经内镜行EMR或ESD治疗后随访48周,合并高级别上皮内瘤变组有14例复发,其中13例为经EMR治疗患者,1例为ESD治疗患者;合并中低级别上皮内瘤变组,有10例复发,均为EMR治疗。结论男性、年龄>45岁、吸烟、有家族史、多发息肉及pit patternⅢ_L及Ⅳ型是结肠癌的高发因素。无论是高级别还是中低级别上皮内瘤变,采用ESD方法治疗,其复发率均小于EMR方法。Objective To investigate the risk factors of cancerization of colorectal polyp and the effect of endoscopic therapy on the recurrence rate. Methods The information of the patients, who underwent colonoscopy and diagnosed as colorectal polyps with intraepithelial neoplasia by pathology from 2012 to 2015, was collected from our hospital. A retrospective analysis was made for the patients′general condition, polyp characters, endoscopic therapy selected and the follow-up data. Results A total of 91 cases of colorectal polyps with intraepithelial neoplasia were found, including 44 cases of high-grade intraepithelial neoplasia and 47 cases of mid-low-grade intraepithelial neoplasia. The patients′ gender, age, hematochezia, smoking histo-ry, polyps numbersize and pit pattern of two groups were compared, the difference was statistically signifi-cant （P〈0.05）. After treatment with EMR or ESD, a 48-week follow-up was taken. There were 14 patients in high grade intraepithelial neoplasia group with recurrence, including 13 patients treated with EMR and 1 pa-tient treated with ESD. While 10 patients had a recurrence in mid-low-grade intraepithelial neoplasia group and all of them were treated with EMR. Conclusion Male, age over 45 years old, smoking, family history, multiple polyps and IIIL and IV pit pattern were high risk factors of colon cancer. The recurrence rate of ESD treatment was lower than EMR treatment no matter they were the high grade or low grade intraepithelial neo-plasia.

关 键 词：肠息肉 腺瘤 上皮内瘤变 癌变 内镜治疗 

分 类 号：R735.34[医药卫生—肿瘤]