结直肠上皮内瘤变分级的临床病理特点分析  

Analysis of clinicopathological characteristics of colorectal intraepithelial neoplasia grade

作　　者：张舒琪 李国熊[2] 叶孝乾 ZHANG Shuqi;LI Guoxiong;YE Xiaoqian(department of Gastroenterology,the Second Hospital of Jiaxing,Jiaxing,314000,China;Department of Gastroenterology,the Affiliated Hospital of Hangzhou Normal University;Department of Pathology,Armed Police Marine Police Corps Hospital)

机构地区：[1]嘉兴市第二医院消化内科,浙江嘉兴314000 [2]杭州师范大学附属医院消化内科 [3]武警海警总队医院病理科

出　　处：《中国中西医结合消化杂志》2021年第9期646-650,共5页Chinese Journal of Integrated Traditional and Western Medicine on Digestion

摘　　要：目的:探讨结直肠低级别上皮内瘤变(LGIN)、高级别上皮内瘤变(HGIN)的临床特征、病理特点,并探讨其相应关系及临床意义。方法:收集2012年1月—2018年8月行肠镜检查并行活检、留取病理标本的1790例肠上皮内瘤变(IN)患者(其中HGIN 191例,LGIN 1599例)的资料,对其临床特点、病理特点进行回顾性研究。使用SPSS 22.0版统计软件行数据分析。采用χ^(2)检验、Fisher精确检验分析结果与临床特点、病理特点的相应关系。结果:IN在不同年龄层段的发病率不同,发病例数随着患者年龄的增大而增多,LGIN与HGIN的发病率男女之间差异无统计学意义(P>0.05),但在具体年龄分层、病理类型上存在差别(P<0.05),≥60岁人群、绒毛状及管状-绒毛状腺瘤的病理类型可能为LGIN发展成HGIN的部分促进因素,血吸虫感染亦可能促进该过程。结论:患者年龄≥60岁、病变部位位于直肠,病理类型为绒毛状及管状-绒毛状腺瘤或伴血吸虫感染时,其发生HGIN的可能性更大。Objective: To compare the differences between colorectal low-grade intraepithelial neoplasia(LGIN) and colorectal high-grade intraepithelial neoplasia(HGIN) in clinical features, endoscopic characteristics, pathological characteristics.,and the corresponding clinicopathological features were discussed. Methods: We conducted a retrospective, matched case-control, parallel study. Patients admitted with colorectal intraepithelial neoplasia between January 2012 and August 2018 were included in this study(1599 LGIN patients, 191 HGIN patients). The clinical features, the endoscopic and pathological characteristics were collected. The χ^(2) test and the exact probability method of Fisher were calculated by the SPSS 22.0 version. To explore the influence factors of development to colorectal intraepithelial neoplasia. Results: The incidence rate of intraepithelial neoplasia, varies with age, and the number of cases increases with age. There were differences between LGIN and HGIN in patients’ age, pathological type(P<0.05). However, there were no significant difference in patients’ gender(P>0.05). The elderly people(≥60 years), the pathological types of villous adenoma and tubular-villous adenoma may be part of the factors contributing to the development of LGIN into HGIN, and schistosoma’s infection may also contribute to this process. Conclusion: HGIN is more likely to occur in elderly patients(≥60 years), rectal lesions, the pathological types of villous adenoma and tubular-villous adenoma or with intestinalschistosomiasis.

关 键 词：结直肠癌 结直肠上皮内瘤变 高级别上皮内瘤变 临床特点 病理特点 诊断 

分 类 号：R574.62[医药卫生—消化系统]