非壶腹十二指肠息肉的评估：非肿瘤性与肿瘤性病变的比较。
Evaluation of non-ampullary duodenal polyps: comparison of non-neoplastic and neoplastic lesions.
机构信息
Department of Internal Medicine, College of Medicine, The Catholic University of Korea, St. Vincent's Hospital Ji-dong, Paldal-gu, Suwon Si, Gyeonggi-Do 442-723, South Korea.
出版信息
World J Gastroenterol. 2010 Nov 21;16(43):5474-80. doi: 10.3748/wjg.v16.i43.5474.
AIM
To evaluate duodenal polyps, divided into non-neoplastic and neoplastic lesions. In addition, the clinical characteristics of duodenal hyperplastic polyps are determined.
METHODS
We analyzed medical records of 50,114 consecutive patients submitted to for first diagnostic esophago-gastroduodenoscopy between January 2004 and December 2009. We excluded lesions on the ampulla of Vater and submucosal tumors. We studied 510 cases that were diagnosed endoscopically with duodenal polyps and enrolled a total of 221 cases that had undergone tissue biopsy. We analyzed the differences between non-neoplastic and neoplastic lesions, and determined the clinical features of duodenal hyperplastic polyps.
RESULTS
Non-neoplastic lesions were found in 196 patients and neoplastic lesions in 25 patients. On univariate analysis, there were significant differences in shape, location, and size. Polyps more than 10 mm in diameter or polyps in the second portion had independent risk factors for being neoplastic lesions, as identified by multivariate analysis. In 23 cases of hyperplastic polyps (79.3%), they were accompanied by gastro-duodenal pathology, which was possibly associated with Helicobacter pylori.
CONCLUSION
Polyps of more than 10 mm or polyps in the second portion of the duodenum should be evaluated by histological examination.
目的
评估十二指肠息肉，分为非肿瘤性和肿瘤性病变。此外，确定十二指肠增生性息肉的临床特征。
方法
我们分析了 2004 年 1 月至 2009 年 12 月期间 50114 例连续行首次诊断性食管胃十二指肠镜检查患者的病历。我们排除了壶腹和黏膜下肿瘤的病变。我们研究了内镜诊断为十二指肠息肉的 510 例患者，并共纳入了 221 例经组织活检确诊的患者。我们分析了非肿瘤性和肿瘤性病变之间的差异，并确定了十二指肠增生性息肉的临床特征。
结果
在 196 例患者中发现非肿瘤性病变，在 25 例患者中发现肿瘤性病变。单因素分析显示，病变的形态、位置和大小存在显著差异。多因素分析显示，直径大于 10mm 的息肉或位于十二指肠第二部的息肉是肿瘤性病变的独立危险因素。在 23 例增生性息肉（79.3%）中，它们伴有胃十二指肠病变，这可能与幽门螺杆菌有关。
结论
直径大于 10mm 或位于十二指肠第二部的息肉应通过组织学检查进行评估。
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