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大肠息肉的临床及内镜病理特征:1234例分析

Clinical and endoscopic-pathological characteristics of colorectal polyps: an analysis of 1,234 cases.

作者信息

Long Xiaohua, Li Xiaofeng, Ma Lin, Lu Jing, Liao Suhuan, Gui Ruohu

机构信息

Department of Gastroenterology, The Fifth Affiliated Hospital of Sun Yat-sen University Zhuhai 519000, China.

Department of Oncology, The Fifth Affiliated Hospital of Sun Yat-sen University Zhuhai 519000, China.

出版信息

Int J Clin Exp Med. 2015 Oct 15;8(10):19367-73. eCollection 2015.

Abstract

PURPOSE

To analyze the correlation of clinical symptom and endoscopic-pathological characteristics of colorectal polyps.

METHODS

A retrospective study was performed on 1,234 continuous colorectal polyp patients. Their clinical, colonoscopic and pathological data were collected and analyzed.

RESULTS

In 1,234 patients, 46.0% cases were asymptomatic, and 54.0% cases were symptomatic, and the female to male ratio was 2.23:1 and 1.74:1, respectively (P = 0.048). The mean polyp size in symptomatic group was significantly larger than asymptomatic group [7.6±5.1 mm (95% CI: 7.2, 8.0) vs. 6.3±3.7 mm (95% CI: 6.0, 6.6), P < 0.001]. Tubu-villous polyp and villous polyp occurred more frequently in symptomatic group, compared with asymptomatic group (P = 0.002). In symptomatic group, 37.4% cases complained of abdominal pain and 62.6% cases complained of bowel habit alteration. The polyp number in abdominal pain group was larger than bowel habit alteration group (P = 0.036). Three major symptoms of bowel habit alteration were diarrhea, constipation and hematochezia, with proportion of 54.2% (278/513), 27.7% (142/513) and 18.1% (93/513), respectively. The hematochezia group had larger polyp size than diarrhea group (P = 0.001) and consisted of more villous component than the constipation patients (P = 0.005).

CONCLUSION

Almost half of colorectal polyp patients do not complain of bowel symptoms, especially the male. Colorectal polyp patients have bowel habit alteration more commonly than abdominal pain. Half of patients with bowel habit alteration demonstrate diarrhea. The hematochezia patients are more susceptible to advanced adenomas than the diarrhea and constipation ones.

摘要

目的

分析大肠息肉临床症状与内镜 - 病理特征的相关性。

方法

对1234例连续性大肠息肉患者进行回顾性研究。收集并分析他们的临床、结肠镜及病理数据。

结果

1234例患者中,46.0%的病例无症状,54.0%的病例有症状,女性与男性比例分别为2.23:1和1.74:1(P = 0.048)。有症状组息肉平均大小显著大于无症状组[7.6±5.1毫米(95%可信区间:7.2,8.0)对6.3±3.7毫米(95%可信区间:6.0,6.6),P < 0.001]。与无症状组相比,有症状组管状绒毛状息肉和绒毛状息肉发生率更高(P = 0.002)。有症状组中,37.4%的病例主诉腹痛,62.6%的病例主诉排便习惯改变。腹痛组息肉数量多于排便习惯改变组(P = 0.036)。排便习惯改变的三大主要症状为腹泻、便秘和便血,比例分别为54.2%(278/513)、27.7%(142/ /513)和18.1%(93/513)。便血组息肉大小大于腹泻组(P = 0.001),绒毛成分比便秘患者更多(P = 0.005)。

结论

几乎一半的大肠息肉患者无肠道症状主诉,尤其是男性。大肠息肉患者排便习惯改变比腹痛更常见。排便习惯改变的患者中有一半表现为腹泻。便血患者比腹泻和便秘患者更容易患进展性腺瘤。

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