Yamamoto Manabu, Mine Hiroyuki, Kusumoto Hiroki, Maehara Yoshihiko, Sugimachi Keizo
Department of Gastroenterology, Shin-Nakama Hospital, Nakama, Japan.
Hepatogastroenterology. 2004 Jan-Feb;51(55):121-3.
BACKGROUND/AIMS: To determine the role of adenomatous polyps in the development of colorectal cancers, we examined the relationship between the distribution and polyps with different grades of dysplasia (low, high), or/and cancers in the colorectum.
The distribution of 527 polyps with low-grade dysplasia was compared with that of 121 polyps with high-grade dysplasia, and 10 colorectal cancer lesions with adenomatous polyps in 361 patients who underwent total colonoscopy.
The distribution rate of polyps at the distal colon and rectum into polyps with high-grade dysplasia significantly increased in comparison to that into polyps with low-grade dysplasia, respectively (p<0.002). The percentage of polyps with high-grade dysplasia measuring >1 cm significantly increased in comparison to that with low-grade dysplasia measuring >1 cm (p<0.00001). In patients with both adenomatous polyps and colorectal cancers, the polyps with high-grade dysplasia at the distal sites of cancerous lesions increased significantly more than at the proximal sites of cancerous lesions (p<0.05). Polyps with high-grade dysplasia have malignant potentials to intermediate between polyps with low-grade dysplasia and colorectal cancers in our study.
The different distributions of different grades thus suggested that polyps with different grades of dysplasia at various colorectal sites were found to have different malignant potentials for cancer development.
背景/目的:为了确定腺瘤性息肉在结直肠癌发生中的作用,我们研究了结肠直肠中不同程度发育异常(低级别、高级别)的息肉分布与癌症之间的关系,或/和结肠直肠癌与息肉之间的关系。
比较了527例低级别发育异常息肉与121例高级别发育异常息肉的分布情况,以及361例行全结肠镜检查患者中10例伴有腺瘤性息肉的结肠直肠癌病变情况。
与低级别发育异常息肉相比,远端结肠和直肠息肉发展为高级别发育异常息肉的分布率显著增加(p<0.002)。直径>1 cm的高级别发育异常息肉的百分比相比直径>1 cm的低级别发育异常息肉显著增加(p<0.00001)。在同时患有腺瘤性息肉和结肠直肠癌的患者中,癌灶远端部位的高级别发育异常息肉相比癌灶近端部位显著增多(p<0.05)。在我们的研究中,高级别发育异常息肉的恶性潜能介于低级别发育异常息肉和结肠直肠癌之间。
不同程度发育异常息肉的不同分布表明,结肠直肠不同部位不同程度发育异常的息肉具有不同的癌症发生恶性潜能。