伴有和未伴有高级别上皮内瘤变肠道绒毛状腺瘤的特点分析  

Biological Characteristics of Different Pathological Pattern Colorectal Adenoma

作　　者：郭海[1] 张一帆[1] GUO Hai;ZHANG Yi-fan(Department of Gastroenterology,Peking University Shenzhen Hospital,Shenzhen 518036,Guangdong Province,China)

机构地区：[1]北京大学深圳医院消化内科,广东深圳518036

出　　处：《罕少疾病杂志》2022年第6期85-88,共4页Journal of Rare and Uncommon Diseases

摘　　要：目的研究伴有和未伴有高级别上皮内瘤变的肠道绒毛状腺瘤的生物学特征。方法分析北京大学深圳医院2017年12月27日至2021年04月21日消化内镜室收治的经病理诊断为大肠绒毛状腺瘤及伴高级别上皮内瘤变的绒毛状腺瘤患者的临床资料。结果88例绒毛状腺瘤患者中,有男性53例(60.2%),女性35例(39.8%),平均年龄为(57.75±13.36)岁;117例合并高级别瘤变绒毛状患者中,共有男性68例(58.1%),女性49例(60.2%),平均年龄为(60.02±11.75)岁。不同病理类型腺瘤的好发部位,均以直肠和乙状结肠为主。高级别上皮内瘤变发生、生长部位可能与绒毛状腺瘤长径有关。长径越大,高级别内瘤变的发生比例越高;长径<20mm组的高级别上皮内瘤变在乙状结肠的发生比例最高;长径≥20mm组的高级别上皮内瘤变更多见于直肠,且随长径增加,在直肠的分布比例逐渐上升。绒毛状腺瘤的生长部位、腺瘤长径与年龄有关。年龄≥58岁时,长径≥20mm的绒毛状腺瘤发生比例增多;年龄≥60岁时,绒毛状腺瘤在直肠发生比例上升,在乙状结肠发生比例下降。结论伴有和未伴有高级别上皮内瘤变肠道绒毛状腺瘤均多见于直肠及乙状结肠。绒毛状腺瘤及高级别上皮内瘤变的生物学特征可能与腺瘤的长径和年龄有一定相关。Objective To study the biological characteristics of colorectal villous adenoma with large intestine high-grade intraepithelial neoplasia.Methods The clinical data of colorectal villous adenoma and high-grade intraepithelial neoplasia patients who were admitted by Gastroenterological Endoscopy Center in Peking University Shenzhen Hospital from December 27,2017 to April 21,2021 were analyzed.Results Among 88 colorectal villous adenoma cases,there were 53 cases in male(60.2%)and 35 ones(39.8%)in female,the average age of villous adenoma patients was 57.75±13.36 years old.Among 117 high-grade intraepithelial neoplasia cases,there were 68 cases(58.1%)in male and 49 ones(60.2%)in female,the average age of high grade intraepithelial neoplasia is 60.02±11.75 years old.Different pathological types of adenomas are mostly observed in rectum and sigmoid colon.The incidence of high-grade intraepithelial neoplasia and the adenoma growth site were associated with length of adenoma.The larger length,the higher incidence of high-grade intraepithelial neoplasia.The length<20 mm adenomas with high-grade intraepithelial neoplasia were more likely to grow in sigmoid colon.If adenoma length≥20 mm,high level of intraepithelial neoplasia would be inclined to grow in rectum.The larger length,the higher proportion of rectum to be high-grade intraepithelial neoplasia growth site would be.The age of villous adenoma patient was related with its length and lesion site.The age≥58 years old group shared more villous adenoma cases that length≥20 mm.If age≥60 years old,the probability that villous adenomas grew in rectum would increase,with that in sigmoid colon would decrease.Conclusion The length of colorectal adenoma and the age of patient could affect the biological characteristics of colorectal villous adenoma and large intestine high-grade intraepithelial neoplasia.Rectum and sigmoid colon are the most common growth site of colorectal adenomas.

关 键 词：大肠绒毛状腺瘤 高级别上皮内瘤变 临床特点 

分 类 号：R735.37[医药卫生—肿瘤]