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本文分析了大肠腺瘤性息肉489例,男314例,女175例。年龄18—81岁,高峰年龄为51—60岁。分布以乙状结肠和直肠最多见(占65.8％)。大肠腺瘤性息肉的癌变与患者的年龄、息肉的形态、大小、不典型增生程度和组织类型有关。息肉越大、不典型增生程度越重、恶变率越高。绒毛状息肉较混合型及管状息肉易恶变。广基息肉的癌变率为有蒂和亚蒂的三倍。本文对息肉癌变的治疗,特别是内镜下摘除后是否要追加根治性肠切除,认为必须根据息肉的形态,大小及类型,手术的危险性作全面考虑决定。强调定期随访、复查,是预防复发和癌变的重要措施。
This article analyzed 489 cases of colorectal adenomatous polyps, 314 males and 175 females. Age 18-81 years old, peak age is 51-60 years old. The most common distribution was sigmoid colon and rectum (65.8%). The cancerous changes of colorectal adenomatous polyps are related to the patient’s age, polyp morphology, size, dysplasia, and tissue type. The larger the polyp, the heavier the dysplasia, the higher the malignant rate. Fluffy polyps are more likely to be malignant than mixed and tubular polyps. The cancer rate of Guangji polyps is three times that of pedicle and Yadi. In this article, the treatment of polyposis, especially whether it is necessary to add radical resection after endoscopic removal, believes that the decision must be made based on the shape, size and type of polyp, and the risk of surgery. Emphasis on regular follow-up, review, is an important measure to prevent recurrence and cancer.