报告49例大肠腺瘤与癌变的关系及大肠腺瘤癌变的处理。男性26例，女性23例，平均年龄43．7岁，其中癌变14例，癌变率为28．6％。脉瘤癌变与腺癌的大小、部位、腺癌的数目、组织学类型及病人年龄等因素有关。＜1cm腺癌未发生癌变，≤2cm的癌变率为55％，直肠及乙状结肠的腺癌易恶变。管状腺瘤、绒毛状腺癌、管状绒毛状腺癌的癌变率分别为22．7％、41．2％、20％，绒毛状腺癌最易癌变。癌变腺癌的术式选择应根据癌变浸润深度、病理组织分类、癌细胞分化程度、切缘是否有癌残留以及淋巴管和静脉是否有癌浸润等决定。 Reported 49 cases of colorectal adenoma and carcinogenesis and colorectal adenoma cancer treatment. There were 26 males and 23 females with an average age of 43.7 years, of which 14 were cancerous and the cancerous rate was 28.6%. Tumor canceration is related to the size and location of adenocarcinoma, the number of adenocarcinomas, the histological type, and the patient’s age. <1cm adenocarcinoma did not become cancerous, and the cancerous rate of ≤ 2cm was 55%, and adenocarcinoma of the rectum and sigmoid colon was easy to be malignant. Tubular adenomas, villous adenocarcinomas, and tubular villous adenocarcinomas had cancer rates of 22.7%, 41.2%, and 20%, respectively, and villous adenocarcinomas were most likely to be cancerous. The choice of surgery for cancerous adenocarcinoma should be based on the depth of cancer infiltration, histopathological classification, the degree of cancer cell differentiation, whether there is cancer in the margin, and whether the lymphatic vessels and veins have cancer infiltration.