小和微小结直肠息肉中高级腺瘤的危险因素：一项前瞻性单中心研究。

Risk factors for advanced adenomas amongst small and diminutive colorectal polyps: a prospective monocenter study.

机构信息

Hepato-gastroenterology Department, CHU Cochin Port-Royal, France.

出版信息

Dig Liver Dis. 2011 Aug;43(8):609-12. doi: 10.1016/j.dld.2011.02.002.

DOI:10.1016/j.dld.2011.02.002

PMID:21764012

Abstract

BACKGROUND

The management of colorectal polyps <10mm in diameter is controversial. Our aim was to evaluate the rate and risk factors for advanced adenomas and high grade neoplasia amongst small (6-9 mm) and diminutive (1-5mm) colorectal polyps.

METHODS

Endoscopic and pathological reports of colonoscopies performed in our centre were collected prospectively. Advanced adenoma was defined by presence of a villous component and/or high grade dysplasia; high grade neoplasia by presence of high grade dysplasia and/or intramucosal carcinoma.

RESULTS

1468 patients were included (53.1% male, mean age 59.5±14 years); 414 polyps <10mm were detected, 9.9% advanced adenomas and 1.7% high grade neoplasia. Amongst small polyps, 25 (35.2%) were advanced adenomas, mainly due to villous features, and 3 (4.2%) were high grade neoplasia. Polyp size was associated with advanced adenomas (odds ratio=8.47).

CONCLUSION

The rate of advanced adenomas amongst small polyps was 35%, mainly due to the presence of villous features. Polyp size was identified as a risk factor of advanced adenoma amongst polyps <10mm. Given these results, we believe that polypectomy should be warranted for patients presenting with small polyps at computed tomography colonography.

摘要

背景

直径<10mm 的结直肠息肉的处理存在争议。我们的目的是评估 6-9mm 大小的小息肉和 1-5mm 大小的微小息肉中高级别腺瘤和高级别肿瘤的发生率和危险因素。

方法

前瞻性收集了在我们中心进行的结肠镜检查的内镜和病理报告。高级别腺瘤的定义为存在绒毛成分和/或高级别异型增生；高级别肿瘤的定义为存在高级别异型增生和/或黏膜内癌。

结果

共纳入 1468 例患者（53.1%为男性，平均年龄 59.5±14 岁）；发现 414 个<10mm 的息肉，9.9%为高级别腺瘤，1.7%为高级别肿瘤。在小息肉中，25 个（35.2%）为高级别腺瘤，主要与绒毛特征有关，3 个（4.2%）为高级别肿瘤。息肉大小与高级别腺瘤相关（比值比=8.47）。