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目的研究大肠息肉癌变肠镜病理特点及诊治。方法回顾内镜下大肠癌变息肉分布,病理类型及诊治。结果27例,共31个大肠息肉癌变,其中2例2次息肉癌变,1例3次息肉癌变,该组息肉癌变率为5.1%,癌变息肉主要分布在直肠及乙状结肠,共24例,占77.4%,癌变息肉的分布与息肉分布成正相关,绒毛状腺瘤癌变率最高,占22.9%,绒毛管状腺瘤12.9%,管状腺瘤最少见,为2.9%,1例息肉癌变是炎性息肉,≥2.0cm癌变息肉占整个癌变息肉71.0%,息肉癌变以无蒂息肉最高,其次是亚蒂,有蒂最低。活检诊断率为61.9%(13/21),内镜下切除诊断率为100%(16/16)。内镜切除16例,其中9例追加手术,15例直接手术。结论对息肉,尤其是腺瘤应定期复查,甚至应终生定期复查,可明显提高早期癌发现率,减少活检漏诊率。
Objective To study the pathological features, diagnosis and treatment of colorectal cancer with colonoscopy. Methods To review the distribution of endocervical polyps, pathological types and diagnosis and treatment of colorectal cancer. Results A total of 31 cases of colorectal polyposis cancer were found in 27 cases, including 2 cases of second polyps canceration and 3 cases of polypoid carcinoid canceration. The canceration rate of polyp was 5.1%. The cancerous polyps mainly distributed in the rectum and sigmoid colon, with a total of 24 cases (77.4%) %. The distribution of cancerous polyps was positively correlated with the distribution of polyps. The highest rate of carcinogenesis was villous adenoma (22.9%), villous tubular adenoma (12.9%), tubular adenoma (2.9%), polypoid carcinogenesis was inflammatory polyp, ≥2.0cm cancerous polyps accounted for 71.0% of the total cancerous polyps, polyps cancerous polyps with the highest, followed by pedicle, pedicle minimum. Biopsy diagnosis rate was 61.9% (13/21), endoscopic resection diagnosis rate was 100% (16/16). Endoscopic resection in 16 cases, of which 9 cases of additional surgery, 15 cases of direct surgery. Conclusions Polyps, especially adenomas, should be regularly reviewed and even routinely reviewed for life. It can significantly improve the detection rate of early cancer and reduce the missed diagnosis rate of biopsy.