大肠息肉的内镜下表现与病理分析

来源 :北京医学 | 被引量 : 0次 | 上传用户:yokuchan
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目的探讨大肠息肉的好发年龄、肠镜下表现和病理特征。方法回顾性分析2005年1月至2011年1月因腹泻、腹痛、腹部不适等症状于北京朝阳医院内镜中心接受电子结肠镜检查的4800例患者,其中发现大肠息肉者590例。对此590例大肠息肉患者的内镜资料和病理检查结果进行分析。结果肠镜检查大肠息肉的检出率为12.3%(590/4800),其中单发息肉430例(8.96%),多发息肉160例(3.33%),共1128枚息肉。患者年龄8~90岁,平均(48.6±10.3)岁,其中﹥50岁者375例(63.6%)。1128枚息肉中有730枚(64.7%)发生于直肠和乙状结肠;大肠息肉直径﹥2cm有88枚,其中有51枚发生了癌变,癌变率为58%。病理检查:1128枚息肉中716枚为腺瘤性息肉,占63.5%,其中有95枚为癌变息肉,息肉癌变率为8.4%(95/1128)。结论肠镜检查患者中大肠息肉的检出率为12.3%;50岁以上为大肠息肉的好发年龄;好发部位是直肠和乙状结肠;大肠息肉﹥2.0cm者癌变率高;大肠息肉病理多表现为腺瘤性息肉,息肉体积大、绒毛成分含量高及不典型增生重者容易癌变。对年龄超过50岁者建议做肠镜检查,病理诊断为腺瘤性息肉者应给予肠镜下切除治疗。 Objective To investigate the incidence of colon polyps age, colonoscopy and pathological features. Methods A retrospective analysis of 4800 patients who underwent electronic colonoscopy at the endoscopic center of Beijing Chaoyang Hospital from January 2005 to January 2011 was performed on 590 patients with colorectal polyps, including diarrhea, abdominal pain and abdominal discomfort. 590 cases of colorectal polyps in patients with endoscopic data and pathological examination results were analyzed. Results The detection rate of colorectal polyps in colonoscopy was 12.3% (590/4800), of which 430 cases (8.96%) were single polyps and 160 cases (3.33%) were polyp polyps, with a total of 1128 polyps. Patients aged 8 to 90 years, mean (48.6 ± 10.3) years, of which 375 cases (63.6%) were> 50 years old. Of the 1128 polyps, 730 (64.7%) occurred in the rectum and sigmoid colon; 88 in colorectal polyps> 2cm in diameter, of which 51 had cancerous lesions with a canceration rate of 58%. Pathological examination: 716 pieces of 1128 polyps were adenomatous polyps, accounting for 63.5%. 95 of them were cancerous polyps, and the rate of polyps was 8.4% (95/1128). Conclusions The detection rate of colorectal polyps in patients underwent colonoscopy was 12.3%. The prevalence of colorectal polyps was over 50 years old. The predilection sites were rectum and sigmoid colon. The canceration rate of colorectal polyps> 2.0cm was high. Adenoma polyps, polyps, large volume, high content of fuzz and atypical hyperplasia are easy to cancer. Colonoscopy is recommended for patients over 50 years of age, and adenomatous polyps should be treated by endoscopic resection.
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