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在德国结直肠肿瘤是第二常见的恶性肿瘤,多起源于良性息肉(从腺瘤发展至肿瘤)。直视结肠镜仍是诊断和治疗结直肠息肉的金标准。然而,除了不能行内镜直视下息肉切除,CT结肠镜(仿真结肠镜)是具有与内镜类似的诊断效力的又一选择。由于在筛查人群中结肠息肉有较高的发病率(约30%),当仅用于筛查且只有少数病变必须在内镜下切除时,仿真结肠镜是有用的检查。大多数这种病变表现为较低的恶变风险,采用对照检查就足够了。根据一篇综述报道,大小约5~6mm的小息肉恶变潜在风险如下筛检出的75%息肉属于小息肉,其中仅约1.5%~2.0%发展为非典型增生,低于0.05%者发展为肿瘤。生长速度为2年内约生长0.4mm,但亦可见回缩现有关于生长方面的研究很少能提供这些小息肉恶变有多快的可信信息结论小息肉恶变的潜在风险被认为是较低的由于缺乏可信的资料,无法断言这些病变的自发过程对照检查(间隔2~3年)作为筛查中一项适当的检查方法而被推荐,而不是立即行内镜直视下的息肉切除,在此之前进一步研究小息肉的自然生长行为是必要的。
Colorectal tumors are the second most common malignancy in Germany and many originate from benign polyps (from adenomas to tumors). Colonoscopy is still the gold standard for the diagnosis and treatment of colorectal polyps. However, in addition to being unable to perform endoscopic polypectomy, CT colonoscopy (simulated colonoscopy) is yet another option with similar diagnostic efficacy as endoscopy. Because of the high incidence (about 30%) of colonic polyps in the screening population, simulated colonoscopy is a useful test when used only for screening and only a few lesions have to be endoscopically removed. Most of these lesions show a lower risk of malignancy and a controlled study is sufficient. According to a review report, the potential risk of malignant transformation of small polyps ranging in size from 5 to 6 mm is as follows: 75% of the polyps detected are small polyps, of which only about 1.5% to 2.0% develop atypical hyperplasia and less than 0.05% develop Tumor. Approximately 0.4 mm in growth rate within 2 years, but also with retraction Existing studies on growth rarely provide credible information on how malignant the polyps evolve Conclusion The potential risk of malignant transformation of polyps is considered to be low In the absence of credible data, the spontaneous progression of spontaneous progression of these lesions can not be asserted as an appropriate screening test, at intervals of 2 to 3 years, rather than immediate endoscopic polypectomy, Prior to further study of the natural polyp growth behavior is necessary.