摘要
目的探讨锯齿状腺瘤(SA)内镜下形态和病理组织学特征。方法回顾分析南方医院消化内镜中心2002年1月至2005年7月检出的大肠息肉病例,了解SA的检出率、内镜形态、腺管开口分型和病理组织学特征。结果11894例肠镜检查共检出息肉病例1928例(2811枚),检出率为16·21%,其中SA61例(71枚),检出率为0·51%,占息肉构成比为3·16%。SA直径>1cm者占39·44%,明显大于增生性息肉;内镜下表现为有蒂息肉所占的比例(26·76%)高于增生性息肉(13·25%),但低于腺瘤性息肉(43·95%)。1815枚息肉进行腺管开口分型,SA多表现为Ⅲ型腺管开口(41·67%),部分表现为Ⅳ型腺管开口(18·33%),与腺瘤性息肉较接近。SA中度以上异型增生发生率介于管状腺瘤和绒毛状腺瘤之间,并有2·82%的癌变率。结论SA内镜形态、腺管开口分型和病理学特点提示其本质上与增生性息肉不同,与肿瘤性息肉表现类似,具有恶变潜能。
Objective To explore the endoscopic and histopathological features of serrated adenomas （SAs）. Methods The data of patients with colorectal polyps diagnosed in the Digestive Endoscopy Center at Nanfang Hospital from January 2002 to July 2005 were reviewed and the detection rate, endoscopic appearances, pit patterns and histopathological features of SAs were analyzed. Results In 1928 （ 16. 21% ） out of 11 894 patients undergoing colonscopy 2811 polyps were found. Among them 61 patients with 71 polyps were found,with a detection rate of 0. 51%. The SAs,larger than hyperplastic polyps obviously,were found in patients 39. 44% with diameter （larger than 1 cm ）. The incidence of pedunculated polyps in SAs （26. 76% ） was higher than that in hyperplastic polyps （13. 25% ）, but less than in adenomatous polyps （43.95%）. The pit patterns of SAs, were type Ⅲ pit pattern （41.67%） and type Ⅳ pit pattern （ 18. 33% ）, this result was similar to adenomatous polyps. The incidences of moderate and severe dysplasia of SAs were higher than those of tubular adenomas but lower than villous adenomas. The canceration rate of SA was 2. 82%. Conclusion The endoscopic appearances, these of pit patterns and histopathological features of SAs, were different from hyperplastic polyps essentially, but similar to neoplastic polyps with potential malignancy,which should be emphasized in clinical practice.
出处
《中华消化内镜杂志》
2006年第2期81-85,共5页
Chinese Journal of Digestive Endoscopy
关键词
锯齿状腺瘤
增生性息肉
腺瘤性息肉
Serrated adenoma
Hyperplastic polyp
Adenomatous polyp
