佛山地区大肠锯齿状腺瘤的发病情况及临床特点  

The morbidity and clinical characteristics of colorectal serrated adenomas in Foshan areas

作　　者：陆宝钿[1] 李兆滔[1] 崔西玉[1] 杨雪竹 王艺霖[1] 刘韶辉[1] LU Baodian;LI Zhaotao;CUI Xiyu;YANG Xuezhu;WANG Yilin;LIU Shaohui(Department of Gastroenterology,Foshan First People'Hospital,Foshan 528000,China)

机构地区：[1]佛山市第一人民医院消化内科

出　　处：《广州医药》2019年第6期78-82,101,共6页Guangzhou Medical Journal

基　　金：佛山市医学类科技攻关项目(0023409120612063)

摘　　要：目的探讨佛山地区大肠锯齿状腺瘤(SA)的发病特点及其变化规律。方法从佛山市第一人民医院2003—2017年的大肠息肉病理切片中筛选出SA,并总结分析其发病情况及临床特点。结果从6820例结直肠息肉中筛选出SA 402例,占全部息肉数的5.89%,误诊率为65.67%。402例SA中,增生性息肉(HP)176例,传统锯齿状腺瘤(TSA)83例,广基锯齿状腺瘤(SSA)143例。男221例,女181例,男:女为1.22:1,好发年龄为50岁以上。SA分布于直肠的比例最高,占43.28%;检出进展性腺瘤(≥1.0 cm)85例,有34.48%的右半结肠SA会发展为进展性腺瘤,高于左半结肠和直肠;检出45例侧向发育型肿瘤(LST型SA),其中伴高级别上皮内瘤变占20.20%,高于非LST型SA;有25.29%的右半结肠SA呈LST型,高于直肠和左半结肠。结论近15年来佛山地区SA的发病率呈逐渐上升趋势,不同年龄、性别、发病部位、表面形态的SA具有不同的临床特征,误诊率高,需引起内镜医师和病理医师的重视。Objective To study the characteristics and change rule of colorectal serrated adenomas(SA)in Foshan areas.Methods The data from patients with pathologically confirmed SA from Foshan First People'Hospital during 2003—2017 were analyzed.Results 402 cases of SA were collected from 6820 cases of colorectal adenomas,accounting for 5.89%.The misdiagnosis rate of SA was 65.57%.There were 176 cases of HP,83 cases of TSA and 143 cases of SSA.There were 211 males and 181 females.The ratio of male to female was 1.22:1.The predisposing age was over 50 years old.The rectum SA took the most proportion(43.28%).85 cases of progressive adenoma were collected.The proportion of progressive adenoma was 34.48%in the right-sided colon higher than that of the left-sided colon and rectum.45 cases of LST were collected.The proportion of high-grade epithelial neoplasia was 20.20%,higher than that of the non-high grade epithelial neoplasia.The proportion of LST was 25.29%in the right-sided SA,higher than that of the left-sided and rectum.Conclusion In the past 15 years,the incidence of SA was increased in Foshan areas.The characteristics of SA in different age,sex,incidence position,and surface shape were different.The misdiagnose rate of the SA was high and we should pay attention to it.

关 键 词：结直肠肿瘤 锯齿状腺瘤 流行病学 误诊 

分 类 号：R73[医药卫生—肿瘤]