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目的探讨息肉恶变的病理与内镜特征。方法回顾性分析我院10年内电子结肠镜检出的大肠息肉的部位、大小、形态、病理及内镜特征与癌变关系分析。结果4197例肠镜检查中检出大肠息肉718例(944枚),检出率为17.11%,腺瘤性息肉占73.94%,癌变47例,总癌变率为6.73%,其中管状腺瘤510例,绒毛管状腺瘤141例,绒毛状腺瘤47例;增生性息肉占20.02%;炎性息肉占6.04%。息肉分布以直肠、乙状结肠和升结肠为最多;息肉癌变均为腺瘤性息肉,腺瘤体积越大、呈分叶或菜花状、无蒂或广基、含绒毛成分多者越易发生癌变。结论腺瘤癌变与体积大小、形态、绒毛成分含量及不典型增生的递增等因素相关,息肉不论大小均应切除,掌握息肉的癌变特征,对提高大肠息肉恶变的检出率、降低进展癌的发生率有重要意义。
Objective To investigate the pathological and endoscopic features of malignant polyps. Methods A retrospective analysis of 10 years in our hospital colonoscopy detected colorectal polyps location, size, morphology, pathology and endoscopic features and the relationship between cancer. Results 4197 colorectal polyps were detected in 718 cases (944 cases), the detection rate was 17.11%, adenomatous polyps accounted for 73.94%, canceration 47 cases, the total carcinogenesis rate was 6.73%, of which 510 cases of tubular adenoma , 141 cases of villous tubular adenoma and 47 cases of villous adenoma. The proliferative polyps accounted for 20.02%. Inflammatory polyps accounted for 6.04%. Polyps distribution to the rectum, sigmoid colon and ascending colon; polyps cancerous are adenomatous polyps, the larger the adenoma volume was lobulated or cauliflower-like, pedunculated or broad-based, containing villus more easily carcinogenic. Conclusions Adenocarcinoma is related to the size, shape, content of villus and the increasing of atypical hyperplasia. Polyps should be resected regardless of size, and the cancerous features of polyps should be mastered to improve the detection rate of malignant transformation of colorectal polyps and to reduce the progression of cancers The incidence is significant.