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目的探讨结直肠锯齿状腺瘤(SA)的内镜下形态和病理学特征。方法收集并分析1996年1月至2008年5月我院检出的32例SA的内镜和病理资料。结果 32例患者共检出SA60枚,其中35枚为隆起型(无蒂23枚,亚蒂7枚,有蒂5枚),25枚为扁平型。SA常见于乙状结肠及直肠(乙状结肠29枚,直肠11枚)。组织病理学上,管状、管状绒毛状和绒毛状SA分别为41枚、9枚、10枚;不典型增生程度,轻度48枚,中度7枚,重度5枚,其中4枚局部癌变。大于或等于10mmSA较10mm以下的SA不典型增生程度重(P<0.01)。结论大于或等于10mm的SA较10mm以下的SA更易癌变,应引起临床及内镜工作者的重视。
Objective To investigate the endoscopic morphology and pathological features of colorectal serrated adenoma (SA). Methods The endoscopic and pathological data of 32 cases of SA detected in our hospital from January 1996 to May 2008 were collected and analyzed. Results A total of 60 SA60 were detected in 32 patients, of which 35 were elevated (23 without pedicle, 7 with pedicle, 5 pedunculated) and 25 were flat. SA common in the sigmoid colon and rectum (sigmoid colon 29, rectum 11). Histopathology, tubular, tubular villous and villous SA were 41, 9, 10; atypical hyperplasia, mild 48, moderate 7, severe 5, of which 4 were locally cancerous. SA atypical hyperplasia greater than or equal to 10 mmSA and less than 10 mm was more severe (P <0.01). Conclusions SA greater than or equal to 10 mm is more susceptible to carcinogenesis than SA below 10 mm, which should be paid more attention to by clinicians and endoscopists.