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患者年龄和大肠息肉大小对组织病理学结果的影响。

Influence of patient age and colorectal polyp size on histopathology findings.

作者信息

Silva Silvana Marques e, Rosa Viviane Fernandes, Santos Antônio Carlos Nóbrega dos, Almeida Romulo Medeiros de, Oliveira Paulo Gonçalves de, Sousa João Batista de

机构信息

Coloproctology Service, University Hospital of Brasília, Brasília University, Brasília, DF, Brazil.

出版信息

Arq Bras Cir Dig. 2014 Apr-Jun;27(2):109-13. doi: 10.1590/s0102-67202014000200006.

Abstract

BACKGROUND

Colorectal cancer is a major cause of morbidity and mortality and can arise through the adenoma-carcinoma sequence. Colonoscopy is considered the method of choice for population-wide cancer screening.

AIM

To assess the characteristics of endoscopically resected polyps in a consecutive series of patients who underwent colonoscopy at a university hospital and compare histopathology findings according to patient age and polyp size.

METHODS

Retrospective, cross-sectional of 1950 colonoscopy reports from consecutively examined patients. The sample was restricted to reports that mentioned colorectal polyps. A chart review was carried out for collection of demographic data and histopathology results. Data were compared for polyps sized ≤0.5 cm and ≥0.6 cm and then for polyps sized ≤1.0 cm and ≥1.1 cm. Finally, all polyps resected from patients aged 49 years or younger were compared with those resected from patients aged 50 years or older.

RESULTS

A total of 272 colorectal polyps were resected in 224 of the 1950 colonoscopies included in the sample (11.5%). Polyps >1 cm tended to be pedunculated (p=0.000) and were more likely to exhibit an adenomatous component (p=0.001), a villous component (p=0.000), and dysplasia (p=0.003). These findings held true when the size cutoff was set at 0.5 cm. Patients aged 50 years or older were more likely to have sessile polyps (p=0.023) and polyps located in the proximal colon (p=0.009). There were no significant differences between groups in histopathology or presence of dysplasia.

CONCLUSION

Polyp size is associated with presence of adenomas, a villous component, and dysplasia, whereas patient age is more frequently associated with sessile polyps in the proximal colon.

摘要

背景

结直肠癌是发病和死亡的主要原因,可通过腺瘤-癌序列发生。结肠镜检查被认为是全人群癌症筛查的首选方法。

目的

评估在一家大学医院接受结肠镜检查的连续系列患者中经内镜切除息肉的特征,并根据患者年龄和息肉大小比较组织病理学结果。

方法

对1950例连续接受检查患者的结肠镜检查报告进行回顾性横断面研究。样本仅限于提及结直肠息肉的报告。进行图表审查以收集人口统计学数据和组织病理学结果。对直径≤0.5 cm和≥0.6 cm的息肉数据进行比较,然后对直径≤1.0 cm和≥1.1 cm的息肉数据进行比较。最后,将49岁及以下患者切除的所有息肉与50岁及以上患者切除的息肉进行比较。

结果

在纳入样本的1950例结肠镜检查中,有224例(11.5%)切除了总共272个结直肠息肉。直径>1 cm的息肉往往有蒂(p = 0.000),更有可能表现出腺瘤成分(p = 0.001)、绒毛成分(p = 0.000)和发育异常(p = 0.003)。当大小临界值设定为0.5 cm时,这些结果仍然成立。50岁及以上的患者更有可能有无蒂息肉(p = 0.023)和位于近端结肠的息肉(p = 0.009)。两组在组织病理学或发育异常的存在方面没有显著差异。

结论

息肉大小与腺瘤、绒毛成分和发育异常的存在有关,而患者年龄更常与近端结肠的无蒂息肉有关。

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