Wilcox G M, Anderson P B, Colacchio T A
Cancer. 1986 Jan 1;57(1):160-71. doi: 10.1002/1097-0142(19860101)57:1<160::aid-cncr2820570132>3.0.co;2-n.
The proper treatment of adenomatous colonic polyps containing small foci of invasive cancer is controversial because the metastatic potential of these lesions is not precisely known. This article critically reviews all known English language studies of this lesion. Before the introduction of colonoscopic polypectomy, the estimated incidence of metastasis from this lesion was 10.4% (based on 12 studies containing 347 polyps), with a confidence interval (95% level) of 7.4 to 14.1. The incidence of metastasis estimated from lesions removed via colonoscopic polypectomy was 10.1% (based on 13 studies containing 188 polyps), with a confidence interval of 5.9 to 14.8. Differences in the definitions of the involved lesions, study designs, and indications for resection cause problems with case selection bias and make comparison of studies difficult. These problems are discussed in detail. Most studies had broad confidence intervals for the estimated incidence of metastasis because of small sample size. The histopathologic criteria, as reflected in the literature, for considering polypectomy alone as adequate treatment for this lesion are summarized and discussed.
含有小灶性浸润癌的结肠腺瘤性息肉的恰当治疗存在争议，因为这些病变的转移潜能尚不完全清楚。本文对所有已知的关于该病变的英文研究进行了批判性综述。在结肠镜息肉切除术应用之前，据估计该病变的转移发生率为10.4%（基于12项研究，共347个息肉），置信区间（95%水平）为7.4%至14.1%。通过结肠镜息肉切除术切除的病变估计转移发生率为10.1%（基于13项研究，共188个息肉），置信区间为5.9%至14.8%。所涉及病变的定义、研究设计和切除指征的差异导致病例选择偏倚问题，使得研究比较困难。这些问题将详细讨论。由于样本量小，大多数研究对转移发生率的估计置信区间较宽。总结并讨论了文献中所反映的将单纯息肉切除术视为该病变充分治疗的组织病理学标准。
