Adachi M, Muto T, Okinaga K, Morioka Y
Second Department of Surgery, Teikyo University School of Medicine, Tokyo, Japan.
Dis Colon Rectum. 1991 Nov;34(11):981-6. doi: 10.1007/BF02049961.
One hundred twenty-eight small flat adenomas (SFAs) were collected from 101 patients, and the clinicopathologic features were investigated. There were 91 adenomas with mild atypia, 20 with moderate atypia, and 17 with severe atypia. SFAs were found more often in males than in females, with a ratio of 3.4:1, and the malignancy rate in females (31.8 percent) was higher than in males (9.3 percent). About 38 percent of the patients had a history of colorectal carcinoma, and 65 percent had a history of colorectal neoplasms. Of 37 patients whose family history was traced, 21 had cancer families. SFAs were prone to be found in patients with a history of colorectal neoplasms and a cancer family. Malignancy rate increased with increasing size. The overall malignancy rate was 13.3 percent, which was considerably higher than that of ordinary small polypoid adenomas (2.8 percent). SFAs were situated more proximally (30.9 percent) than ordinary adenomas; however, there was no relationship between site and malignancy. All the lesions showed tubular adenomas, and there was no villous feature. A central depression was noted in 20 lesions, more frequently in adenomas with higher atypia. All but one adenoma with severe atypia showed a component of lower atypia, supporting the adenoma-carcinoma sequence.
从101例患者中收集了128个小扁平腺瘤（SFA），并对其临床病理特征进行了研究。其中91个腺瘤为轻度异型增生，20个为中度异型增生，17个为重度异型增生。SFA在男性中比在女性中更常见，比例为3.4:1，女性的恶性率（31.8%）高于男性（9.3%）。约38%的患者有结直肠癌病史，65%有结直肠肿瘤病史。在37例追踪家族史的患者中，21例有癌症家族史。SFA易见于有结直肠肿瘤病史和癌症家族史的患者。恶性率随大小增加而升高。总体恶性率为13.3%，明显高于普通小息肉状腺瘤（2.8%）。SFA比普通腺瘤更靠近近端（30.9%）；然而，部位与恶性之间没有关系。所有病变均为管状腺瘤，无绒毛特征。20个病变中有中央凹陷，在异型性较高的腺瘤中更常见。除1个重度异型增生腺瘤外，所有腺瘤均显示低异型性成分，支持腺瘤-癌序列。
