Bém J, Jedlicka J, Bém S
Department of Patology, State University of New York, Buffalo, USA.
Rozhl Chir. 2000 Jul;79(7):283-5.
It is important for the general surgeon to have a clear idea of what is a malignant polyp and factors determining its clinical management. A malignant polyp is either sessile or pedunculated and harbors an invasive carcinoma which means that malignant cells have penetrated into or through the muscularis mucosae. Carcinoma in situ, intramucosal carcinoma, superficial carcinoma, carcinoma within the the mucosa or lamina propria are terms commonly used that must be distinguished from true invasive malignancy. These polyps should be treated by complete polypectomy and followed up as in a benign polyp. A polyp with invasive carcinoma requires careful evaluation to make a decision if simple polypectomy is sufficient treatment or whether surgical treatment is indicated. This decision is based on the risk factors such as a residual/recurrent tumour and the risk of lymph node metastases. We present a current review of the literature on the subject.
对于普通外科医生来说,清楚了解什么是恶性息肉以及决定其临床管理的因素非常重要。恶性息肉要么是无蒂的,要么是有蒂的,并且含有浸润性癌,这意味着癌细胞已经侵入或穿透黏膜肌层。原位癌、黏膜内癌、浅表癌、黏膜或固有层内的癌是常用术语,必须与真正的浸润性恶性肿瘤区分开来。这些息肉应通过完整的息肉切除术进行治疗,并像良性息肉一样进行随访。伴有浸润性癌的息肉需要仔细评估,以决定单纯息肉切除术是否足以治疗,或者是否需要手术治疗。这个决定基于诸如残留/复发性肿瘤和淋巴结转移风险等危险因素。我们对该主题的文献进行了当前综述。