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背景:结直肠息肉特别是腺瘤性息肉为结直肠癌前病变,结肠镜检查检出并切除息肉对结直肠癌的预防具有重要意义。目的:对上海市嘉定区1 613例结直肠息肉患者进行回顾性分析,为结直肠息肉的内镜监测管理提供依据。方法:2013年1月—2014年8月上海瑞金医院北院内镜中心检出的2 652枚结直肠息肉纳入研究,对息肉临床病理特征、活检与内镜切除标本病理诊断符合率以及随访期间息肉再次检出情况进行统计分析。结果:2 652枚结直肠息肉中75.3%(1 996枚)为远端结肠息肉,腺瘤性息肉占77.5%(2 056枚),其中39.1%(804枚)发生上皮内瘤变。447枚息肉同时取活检并在切除后送病理检查,两次病理诊断总体符合率为60.4%,其中腺瘤性息肉符合率为68.1%。术后1.5年复查结肠镜再次检出息肉并送病理检查共218枚,腺瘤性息肉占74.3%,近端结肠和直径≤1.0 cm的息肉再次检出率分别显著高于远端结肠和直径>1.0 cm者(12.3%对6.9%,9.0%对4.5%,P均<0.01)。结论:腺瘤性息肉在结肠镜检查检出的息肉中占比较高;应重视息肉切除后标本的病理检查和定期随访。
BACKGROUND: Colorectal polyps, especially adenomatous polyps, are premalignant colorectal lesions. Colonoscopy and resection of polyps are of great importance for the prevention of colorectal cancer. Objective: To retrospectively analyze 1 613 cases of colorectal polyps in Jiading District, Shanghai, and provide the basis for endoscopic surveillance of colorectal polyps. Methods: From January 2013 to August 2014, 2 652 colorectal polyps detected in the endoscopic center of Shanghai Ruijin Hospital were included in the study. The clinical and pathological characteristics of polyps, the coincidence rate of pathological diagnosis of biopsy and endoscopic resection and follow-up Polyps again detected the situation for statistical analysis. Results: 75.3% (1,996) of 2 652 colorectal polyps were distal colonic polyps, adenomatous polyps accounted for 77.5% (2 056), of which 39.1% (804) had intraepithelial neoplasia. 447 polyps were taken biopsy simultaneously and sent for pathological examination after resection. The overall coincidence rate of two pathological diagnosis was 60.4%, of which the coincidence rate of adenomatous polyps was 68.1%. Postoperatively 1.5 years after colonoscopy, polyps were detected again and sent for pathological examination, a total of 218, adenomatous polyps accounted for 74.3%, the proximal colon and diameter ≤ 1.0 cm polyp re-detection rates were significantly higher than the distal colon and diameter > 1.0 cm (12.3% versus 6.9%, 9.0% versus 4.5%, P <0.01). Conclusion: Adenomatous polyps have a high proportion of polyps detected by colonoscopy. Pathological examination and regular follow-up of polyp samples should be emphasized.