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基于内镜检查结果及临床病理特征诊断的血吸虫病合并结直肠癌:32例报告

Schistosomiasis combined with colorectal carcinoma diagnosed based on endoscopic findings and clinicopathological characteristics: a report on 32 cases.

作者信息

Liu Wei, Zeng Hong-Ze, Wang Qi-Ming, Yi Hang, Mou Yi, Wu Chun-Cheng, Hu Bing, Tang Cheng-Wei

机构信息

Digestive Endoscopy Center, Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, Sichuan, China E-mail :

出版信息

Asian Pac J Cancer Prev. 2013;14(8):4839-42. doi: 10.7314/apjcp.2013.14.8.4839.

Abstract

AIMS AND BACKGROUND

To improve understanding of the relationship between schistosome-related enteropathy and colorectal carcinoma with particular focus on endoscopic findings and clinicopathological characteristics of colonic schistosomiasis.

MATERIALS AND METHODS

All cases of intestinal schistosomiasis diagnosed at West China Hospital, Chengdu, China, between October 2006 and October 2012 were included in this study. A total of 179 cases of colonic schistosomiasis diagnosed through colonoscopy and pathological examinations were collected for analysis and the demographics, symptoms, endoscopic findings and clinicopathological characteristics were retrospectively evaluated.

RESULTS

Of the 179 colonic schistosomiasis patients, 32 combined with colorectal cancer (CRC) were found, between the ages of 44 and 85 years (24 males, 75%). These 32 lesions were classified as 12 endophytic/ulcerative (37.5%), 10 exophytic/fungating (31.2%), 4 annular (12.5%), 3 giant polypus (9.4%), and 3 IIc (superficial depressed type) (9.4%). The segments of rectum and sigmoid colon were involved in 19 patients (59.4%) and 6 patients (18.8%), respectively. The histopathologic types were classified as follows: 30 well- differentiated adenocarcinomas, one mucinous adenocarcinoma and one poorly differentiated adenocarcinoma. The pathological findings suggest colorectal malignancy with deposited schistosome ova.

CONCLUSIONS

Chronic schistosomal infestation has a probable etiological role in promoting genesis of colorectal neoplasms.

摘要

目的与背景

为了更好地理解血吸虫相关性肠病与结直肠癌之间的关系,特别关注结肠血吸虫病的内镜检查结果和临床病理特征。

材料与方法

本研究纳入了2006年10月至2012年10月在中国成都华西医院诊断的所有肠道血吸虫病病例。共收集了179例经结肠镜检查和病理检查确诊的结肠血吸虫病病例进行分析,并对其人口统计学、症状、内镜检查结果和临床病理特征进行回顾性评估。

结果

在179例结肠血吸虫病患者中,发现32例合并结直肠癌(CRC),年龄在44岁至85岁之间(男性24例,占75%)。这32个病变分类如下:12例内生/溃疡性(37.5%),10例外生/蕈伞状(31.2%),4例环状(12.5%),3例巨大息肉(9.4%),3例IIc型(浅表凹陷型)(9.4%)。直肠和乙状结肠段分别累及19例患者(59.4%)和6例患者(18.8%)。组织病理学类型分类如下:30例高分化腺癌,1例黏液腺癌和1例低分化腺癌。病理结果提示为伴有血吸虫卵沉积的结直肠恶性肿瘤。

结论

慢性血吸虫感染在促进结直肠肿瘤发生方面可能具有病因学作用。

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