结直肠锯齿状息肉的临床、内镜及病理特征分析  

Analysis of clinical, endoscopic and pathological features of colorectal serrated polyp

作　　者：张珊妍 刘岚[1] 吴洪磊[1] 辛玉 肖娟[2] 朱孔锡[1] 郭建强[1] Shan-yan Zhang;Lan Liu;Hong-lei Wu;Yu Xin;Juan Xiao;Kong-xi Zhu;Jian-qiang Guo(Department of Gastroenterology,the Second Hospital of Shandong University,Jinan,Shandong 250033,China;Evidence-based Medicine Center,the Second Hospital of Shandong University,Jinan,Shandong 250033,China)

机构地区：[1]山东大学第二医院消化内科,山东济南250033 [2]山东大学第二医院循证医学中心,山东济南250033

出　　处：《中国现代医学杂志》2018年第19期95-100,共6页China Journal of Modern Medicine

摘　　要：目的探究结直肠锯齿状息肉(SP)的临床、内镜及病理特征。方法回顾性分析2013年9月-2016年5月山东大学第二医院内镜中心检出的232例结直肠SP患者的临床内镜及病理资料,采用χ~2检验对SP不同病理分型的内镜特征进行比较。结果232例SP患者,男153例,女79例;年龄18~86岁,平均(52.38±12.67)岁。共检出251枚SPs,增生性息肉(HP)165枚(65.7%)、无蒂锯齿状腺瘤/息肉(SSA/P)85枚(33.9%)和传统锯齿状腺瘤(TSA)1枚(0.4%)。HP和SSA/P在息肉分布部位、大小及形态方面的差异有统计学意义(χ~2=14.68、37.98和74.83,均P=0.000)。85枚SSA/P中,伴和未伴细胞异型增生型分别为66枚(77.6%)和19枚(22.4%)。两者息肉形态的比较,差异有统计学意义(χ~2=5.98,P=0.015),而息肉分布部位及大小比较差异均无统计学意义(χ~2=0.07和1.56,P=0.932和0.211)。结论HP和SSA/P有其自身的内镜特点,结合息肉部位、大小及形态有助于区分。而SSA/P不同病理分型的内镜特点,仍需要扩大样本量进一步研究。Objective To investigate clinical,endoscopic and pathological features of colorectal serrated polyp(SP).Methods Clinical,endoscopic and pathological data of 232 patients with at least one colorectal serrated polyp detected at Endoscopic Center of the Second Hospital of Shandong University from September 2013 to May 2016 were retrospectively analyzed.Endoscopic features of different pathological types of SP were compared byχ2 test.Results In the 232 patients with at least one colorectal serrated polyp,there were 153 males and 79 females,with the age ranging from 18 to 86 y and the mean age of(52.38±12.67)y.There were totally 251 SPs,including 165 hyperplastic polyps(HP,65.7%),85 sessile serrated adenomas or polyps(SSA/P,33.9%),and 1 traditional serrated adenoma(TSA,0.4%).Significant differences were observed between HP and SSA/P in the location,size and morphology(χ2=14.68,37.98 and 74.83,P=0.000).The proportions of 66 SSA/P with dysplasia and 19 SSA/P without dysplasia in the 85 SSA/P were 77.6%and 22.4%,respectively.A significant difference was observed between the two groups in the morphology(χ2=5.98,P=0.015),whereas no significant difference was observed in the location or size(χ2=0.07 and 1.56,P=0.932 and 0.211).Conclusions HP and SSA/P have their own endoscopic features,and combination with location,size and morphology of polyps helps to distinguish them.However,with respect to endoscopic features of different pathological types of SSA/P,we still need to enlarge the sample size for further study.

关 键 词：结直肠锯齿状息肉 增生性息肉 无蒂锯齿状腺瘤/息肉 传统锯齿状腺瘤 

分 类 号：R656.9[医药卫生—外科学]