结肠息肉的临床病理特征及其与癌变的相关分析  

Cfinical and pathological features of colon polyps and risk factors for colon polyps

作　　者：安俊平[1] 刘彬[1] 师艾丽[1] 陈启龙[1] 

机构地区：[1]徐州市肿瘤医院消化科,徐州221000

出　　处：《中国医师杂志》2017年第7期1035-1037,1042,共4页Journal of Chinese Physician

摘　　要：目的分析结肠息肉患者的临床病理特征，探讨结肠息肉癌变相关危险因素。方法收集本院接诊的结肠息肉摘除术患者80例[其中6例为高级别上皮内瘤变（下文简称癌变）患者]，另收集同期结肠息肉摘除术并经病理检测证实为结肠癌患者20例，将上述患者分为74例非癌变组与26例癌变组。收集两组患者的临床资料、各项检测指标及病理检测结果。结果80例结肠息肉患者6例显示为癌变（3．14％）；共摘除191颗息肉；直肠、盲肠发生炎性息肉的风险显著高于其他结肠部位；横结肠发生管状腺瘤的风险显著高于其他结肠部位；乙状结肠息肉发生癌变的风险最高（OR=2．30，P〈0．05）；管状绒毛腺瘤癌变的风险最高（OR=30．10，P〈0．01），其次为绒毛状腺瘤癌变（OR=13．40，P〈0．01），管状腺瘤癌变风险最小（P〉0．05）。单因素分析显示，病理类型、病变部位与结肠息肉癌变相关（P〈0．05）；多因素非条件Logistic回归分析显示，WBC、病理类型、病变部位是结肠息肉癌变的主要危险因素（P〈0．05）。结论直肠、盲肠是息肉的好发部位，病理特征主要表现为管状腺瘤、炎性、增生性息肉；乙状结肠发生息肉癌变的风险最高；病理类型、病变部位是结肠息肉癌变的主要危险因素。Objective To investigate the clinical and pathological features of colonic polyp cancer- ation and related risk factors of colon polyps, and explore clinicopathologic features and major risk factors of the canceration of polyps of colon polyps. Methods Totally 80 patients with colon polyps including 6 cases of cancerations and 20 patients with colon cancers were selected from Xuzhou Tumor Hospital Admissions. Those patients were divided into 74 cases of non cancer group and 26 cases of cancer group. The clinical da- ta, the detection index and the statistical analysis were performed. Results The clinical features of patients included 51 cases of multiple polyps, 30 cases of fatty liver, 13 cases of fecal occult blood positive, and 30 patients with colonoscopy. There were 218 polyps, 191 data intact, and 6 cases showed cancer （3.14%）. Inflammatory polyps mainly occurred in rectum, cecum, and significant risk other than the colon. Tubular adenoma occurred mainly in the transverse colon. Sigmoid colon cancer colon polyps of the highest risk showed OR = 2. 30 （P 〈 0. 05）. The cancer risk from high to low was from tubular villous adenoma to vil- lous adenoma hair （ P 〈 0. 01 ）, and no difference in tubular adenoma cancer risk （ P 〉 0. 05 ）. There was no difference between the indexes of the canceration group and the non cancerous group （ P 〉 0. 05 ）. The single factor analysis showed pathological type, and the lesion were the main risk factors of malignant colonic polyps （P 〈 0. 05 ）. Multi-factor regression analysis showed WBC, pathological type, and the lesion were the main risk factors of malignant colonic polyps （ P 〈 0. 05 ）. Conclusions The colonic polyps in male have higher incidence with fatty liver, hypertension and other pathological features, and are mainly tubular adenomas, inflammatory and hyperplastic polyps, with different lesions, pathological types occur and different cancer risk.

关 键 词：结肠息肉/病理学 结肠肿瘤 危险因素 

分 类 号：R735.35[医药卫生—肿瘤]