结直肠腺瘤性息肉及其早期癌变的诊治进展  

Clinical management of colorectal adenomatous polyp carcinogenesis

作　　者：孙浩杰 陈丙学 莫琪[1] 刘建峰[1] 徐强[1] Sun Haojie;Chen Bingxue;Mo Qi;Liu Jianfeng;Xu Qiang(Department of Anorectal Surgery,Changzhou Second People’s Hospital Affiliated to Nanjing Medical University,Changzhou 213000,China)

机构地区：[1]南京医科大学附属常州市第二人民医院肛肠外科,213000

出　　处：《中华实验外科杂志》2022年第9期1831-1833,共3页Chinese Journal of Experimental Surgery

基　　金：常州市医学创新团队项目(CCX201807)。

摘　　要：结直肠息肉包括肿瘤性和非肿瘤性息肉,前者指腺瘤,当前被认为是最重要的结直肠肿瘤的癌前病变。目前认为,大多数的结直肠癌发生需经历腺瘤-癌的发展序列,即从肠上皮异型增生,演化至腺瘤形成,进一步癌变发展为浸润性癌,甚至转移扩散。通过结肠镜检查可早期发现并合理处置腺瘤及癌变息肉,符合"早期发现、早期诊断、早期治疗"的三级预防策略。然而就临床中明确诊断的结直肠恶性息肉该如何正确处理,选择内镜下治疗还是手术扩大切除目前尚无统一定论。通过大量阅读国内外文献并结合临床经验,作如下综述总结,以期明确和规范结直肠腺瘤癌变的治疗。Colorectal polyps include both neoplastic and non-neoplastic polyps,the former referring to adenomas,which are currently considered to be the most predominant colorectal tumor precancerous lesion.It is currently believed that most colorectal carcinogenesis requires an adenoma-carcinoma development sequence,that is,from intestinal epithelial heterogeneous proliferation,evolution to adenoma formation,further carcinoma development to invasive carcinoma,and even metastasis spread.Colonoscopy can detect adenomas and cancerous polyps at an early stage and deal with them reasonably,which is in line with the tertiary prevention strategy of"early detection,early diagnosis and early treatment".However,what is the proper treatment for malignant colorectal polyps that are clearly diagnosed in clinical practice?Endoscopic treatment?Or surgical resection?There is no unified conclusion yet.Through extensive reading of literature,we summarizes the following review in order to clarify and standardize the treatment of colorectal adenoma carcinogenesis.

关 键 词：腺瘤癌变 恶性息肉 治疗 

分 类 号：R735.34[医药卫生—肿瘤]