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目的探讨结直肠锯齿状腺瘤(SA)的内镜下形态和病理组织学特征。方法回顾性分析2001年1月至2016年3月上海普陀区人民医院病理科68例患者检出的100枚SA的内镜和病理资料。结果 100枚中SA有81枚隆起型(无蒂63枚,亚蒂10枚,有蒂8枚),19枚为扁平型,表现扁平;检出部位于直肠23枚、乙状结肠33枚,其他44例。组织病理学类型,表现管状、管状-绒毛状和绒毛状SA分别为51、20、29枚;轻度、中度和重度不典型增生分别为58、22、20枚。直径<10 mm的SA增生程度轻于直径≥10 mm的SA(P<0.01)。结论结直肠不典型增生息肉可能为SA。SA可能是直结肠肿瘤癌前病变,临床病理的合理利用,能提高癌变的检出率。
Objective To investigate the endoscopic morphology and histopathological features of colorectal serrated adenoma (SA). Methods A retrospective analysis was performed on the endoscopic and pathological data of 100 SA patients detected in 68 patients in the Putuo District People’s Hospital of Shanghai from January 2001 to March 2016. Results There were 81 uplift type (no pedicle 63, pedicle 10, pedicle 8) in SA of 100, and flat type 19 in flat SA, with 23 in rectum, 33 in sigmoid colon and 44 in other example. Histopathological types, tubular manifestations, tubular - villous and villous SA were 51,20,29; mild, moderate and severe dysplasia were 58,22,20. The degree of SA hyperplasia with diameter <10 mm was less than that with SA≥10 mm (P <0.01). Conclusion Colorectal atypical hyperplastic polyps may be SA. SA may be premalignant lesions of colorectal cancer, the rational use of clinical and pathological, can improve the detection rate of cancer.