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目的 :探讨肠镜下大肠腺瘤的分布、大小、形态、病理特征与腺瘤癌变的关系及其诊治方法。方法 :选择80 4例病理证实为大肠腺瘤或腺瘤癌变的病例 ,分析大肠腺瘤大小、位点、基蒂特点和组织学特征对腺瘤癌变的影响。结果 :发现 80 4例共 112 6枚大肠腺瘤 ,腺瘤癌变 46例 (4 6枚 ) ,癌变发生率 4.1%。直肠、乙状结肠腺瘤 897枚 ,占腺瘤总数的 79.7% ,其中癌变腺瘤 39枚 ,占癌变腺瘤总数的 84.8%。直径大于 2 .0cm的腺瘤癌变率 17.2 % (2 6 / 15 1) ,1.0～ 2 .0cm腺瘤癌变率为 5 .5 % (15 / 2 71)。广基腺瘤癌变率为 11.5 % (2 6 / 2 2 6 ) ,短蒂或亚蒂者为 3.1% (18/ 5 74)。绒毛状腺瘤癌变率 2 2 .1% (2 1/ 95 ) ,管状绒毛状腺瘤 9.4% (15 / 15 9) ,管状腺瘤 1.1% (10 / 872 )。结论 :直肠、乙状结肠是大肠腺瘤及腺瘤癌变的好发部位 ,直径大于 2 .0cm腺瘤、广基腺瘤、绒毛状腺瘤和管状绒毛状腺瘤有较高的癌变危险性。积极治疗大肠腺瘤是防治大肠癌的有效措施之一。
Objective: To investigate the distribution, size, shape, and pathological features of colon adenoma under colonoscopy and its relationship with the diagnosis and treatment of adenoma. METHODS: Eighty-four patients with pathologically confirmed colorectal adenomas or adenomas were selected and analyzed for the effects of colorectal adenoma size, location, Kitty characteristics, and histological features on the carcinogenesis of adenomas. RESULTS: A total of 1,126 of 6 large intestine adenomas were identified in 80 4 cases. 46 cases (46) of adenomas were cancerous and the incidence of canceration was 4.1%. There were 897 rectal and sigmoid adenomas accounting for 79.7% of the total number of adenomas, including 39 cancerous adenomas, accounting for 84.8% of the total number of cancerous adenomas. The cancerous rate of adenomas larger than 2.0 cm in diameter was 17.2% (2 6 / 15 1), and the cancerous rate of 1.0 to 2.0 cm adenomas was 5% (15 / 2 71). The cancerous rate of broad-based adenomas was 11.5% (2 6 / 2 6), and 3.1% (18/ 5 74) was short-tied or pedicled. The villous adenomas had a cancerous rate of 2 2.1% (2 1/95), tubular villous adenomas 9.4% (15/15), and tubular adenomas 1.1% (10/872). Conclusions: Rectal and sigmoid colons are the predominant sites of colorectal adenomas and adenomas. Adenomas, broad-based adenomas, villous adenomas, and tubular villous adenomas with a diameter larger than 2.0 cm have a higher risk of canceration. Active treatment of colorectal adenoma is one of the effective measures to prevent colorectal cancer.