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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2002年1月至2005年7月南方医院消化内镜中心检出的71枚SA的内镜和病理资料。结果71枚SA中47枚为隆起型(无蒂23枚,亚蒂5枚,有蒂19枚),24枚为表面型(扁平16枚,侧向发育型8枚),平均大小分别为10.5mm和16.6mm,常见于直肠及乙状结肠。组织病理学上,管状、管状绒毛状和绒毛状SA分别为53、9和9枚;不典型增生程度,轻度47枚,中度22枚,2枚局部有癌变病灶。10mm以下的SA不典型增生程度较大于或等于10mmSA轻(P<0.01)。腺管开口(pit)分型的60枚SA中,Ⅳ型SA多由绒毛状腺体(64%)组成,ⅢL型SA多由管状腺体(68%)组成,但有40%的SA(24枚)表现为增生性息肉样的Ⅱ型,全部由管状腺体组成;腺体异型性Ⅱ型与ⅢL型相近而小于Ⅳ型息肉(P<0.05)。结论Ⅱ型pit的息肉可能为SA。SA具有肿瘤性息肉的一般特点,应视为一种新的可能性癌前病变。
Objective To investigate the endoscopic morphology and histopathological features of colorectal serrated adenoma (SA). Methods A retrospective analysis of the endoscopic and pathological data of 71 SA patients from the digestive endoscopy center of Southern Hospital from January 2002 to July 2005 was performed. RESULTS: Forty-seven of the 71 SA were hyperkeratotic (23 pedunculated, 5 pedunculated, 19 pedunculated) and 24 were surface type (flattened 16, lateral developed 8) with an average size of 10.5 mm and 16.6mm, common in the rectum and sigmoid colon. Histopathology, tubular, tubular villous and villous SA were 53,9 and 9; atypical hyperplasia, mild 47, moderate in 22, 2 local cancer lesions. SA dysplasia below 10 mm was greater than or equal to 10 mmSA light (P <0.01). Among the 60 SA typed with pits, type IV SA mostly consisted of villous glands (64%), while type III L SA was mostly composed of tubular glands (68%) with 40% SA 24) showed hyperplastic polyps type Ⅱ, all composed of tubular glands; glandular type Ⅱ and ⅢL similar but less than type Ⅳ polyps (P <0.05). Conclusion The type Ⅱ pit polyp may be SA. SA has the general characteristics of tumor polyps, should be considered as a new possibility of precancerous lesions.