结直肠锯齿状腺瘤内镜和病理形态特征分析.doc

结直肠锯齿状腺瘤内镜和病理形态特征分析 结直肠锯齿状腺瘤内镜和病理形态特征分 析 2006年4月第23卷第2期ChinJDigEndP::. 结直肠锯齿状腺瘤内镜和病理形态 特征分析 张婉雯任宝军童华生张亚历姜泊 【摘要】目的探讨锯齿状腺瘤(SA)内镜下形态和病理组织特方法回顾分析南方医 院消化内镜中心2002年1月至2005年7月检出的大肠息肉病例,了SA的检出率,内镜形态,腺管 开口分型和病理组织学特征.结果11894例肠镜检查共检出息肉病例1928例(2811枚),检出率 为l6.21%,其中SA61例(71枚),检出率为0.51%,占息肉构成比为3.16%.SA直径gt;1cm者占 39.44%,明显大于增生性息肉;内镜下表现为有蒂息肉所占的比例(26.76%)高于增生性息肉 (13.25%),但低于腺瘤性息肉(43.95%).1815枚息肉进行腺管开口分型,SA多表现为?型腺管开 口(41.67%),部分表现为?型腺管开口(18.33%),与腺瘤性息肉较接近.SA中度以上异型增生发 生率介于管状腺瘤和绒毛状腺瘤之间,并有2.82%的癌变率.结论SA内镜形态,腺管开口分型和 病理学特点提示其本质上与增生性息肉不同,与肿瘤性息肉表现类似,具有恶变潜能. 【关键词】锯齿状腺瘤;增生性息肉;腺瘤性息肉 Analysisofthecharacteristicsofendoscopicandhistopathoiogiealfeaturesofcoiorectalserr atedade- nolnssZHANGWan—wen,RENBao-jun,TONGHua—sheng,ZHANGIra— li,J1ANGBo.ThelnsitituteforD— gestweMedicine,NanfangHospital,SouthernMedicalUniversity,Guangzhou510515,China Correspondingauthor:Jiangbo,Email:drfiang@163.coyn 【Abstract】 0bjectiveToexploretheendoscopicandhistopathologicalfeaturesofserratedadeno— mas(SAs).MethodsThedataofpatientswithcolorectalpolypsdiagnosedintheDigestiveEndoscopy CenteratNanfangHospitalfromJanuary2002toJuly2005werereviewedandthedetectionrate,endoscopic appearances,pitpatternsandhistopathologicalfeaturesofSAswereanalyzed.ResultsIn1928(16.21%) outof11894patientsundergoingcolonscopy2811polypswerefound.Amongthem61patientswith71polyps werefound,withadetectionrateof0.51%.TheSAs,largerthanhyperplasticpolypsobviously.weref0undin patients39.44%withdiameter(1argerthan1cm).TheincidenceofpedunculatedpolypsinSAs (26.76%)washiigherthanthatinhyperplasticpolyps(13.25%),butlessthaninadenomatouspolyps (43.95%).ThepitpatternsofSAs,weretype?pitpattern(41.67%)andtypeIVpitpattern (18.33%),thisresultwassimilartoadenomatouspolyps.Theincidencesofmoderateandseveredysplasia ofSAswerehigherthanthoseoftubularadenomasbutlowerthanvillousadenomas.Thecancerationrateof SAWaS2.82%.ConclusionTheendoscopicappearances,theseofpitpatternsandhistopathologicalfea— turesofSAs,weredifferentfromhyperplasticpolypsessent