The clinical and pathological characteristics of advanced colorectal adenomatous polyps_West China Medical Journal

Authors：

 HUANG Zhong , ZHANG Jie , CHENG Fang , HOU Cong , CHEN Xinlian

Division of Gastroenterology, Zigong First People’s Hospital, Zigong, Sichuan 643000, P. R. China;

Corresponding?author：

HUANG Zhong, Email: hzdtg@sina.com

Keywords：

Adenomatous polyp; Intraepithelial neoplasia; Pathology; Canceration

DOI：

10.7507/1002-0179.201912241

Video：

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Objective To investigate the clinical and pathological characteristics of advanced colorectal adenomatous polyps. Methods Patients with colorectal adenomatous polyps diagnosed after colonoscopy in the Division of Gastroenterology of Zigong First People’s Hospital from January 2013 to March 2019 were selected. The patients were divided into advanced colorectal adenomatous polyps group (advanced group) and non advanced colorectal adenomatous polyps group (non advanced group), to analyze the location distribution, pathological type and the relationship with carcinogenesis of advanced colorectal adenomatous polyps. Results A total of 1 555 patients were included. There were 223 cases (14.34%) in the advanced group and 1 332 cases (85.66%) in the non advanced group. There was no significant difference in the distribution of canceration in postoperative pathological examination (P=1.000), but there was significant difference in other indexes between the two groups (P<0.05). The detection rate of high-grade intraepithelial neoplasia in the advanced group was higher in tubular adenoma than that in villous-tubular adenoma (41.18% vs. 13.74%; χ²=18.959, P<0.001). There was no significant difference in the detection rate of high-grade intraepithelial neoplasia between tubular adenoma and villous adenoma (41.18% vs. 25.00%; χ²=1.992, P=0.220). In the advanced group, 40 cases (17.94%) were at the right colon and 183 cases (82.06%) at the left colon. In the detection rate of high-grade intraepithelial neoplasia in the left colon, there was no significant difference between villous adenoma and villous-tubular adenoma (17.65% vs. 14.41%; χ²=2.801, P=0.094) or tubular adenoma (17.65% vs. 41.82%; χ²=3.289, P=0.088); the rate in tubular adenoma was higher than that in villous-tubular adenoma (41.82% vs. 14.41%; χ²=9.322, P=0.002). There was no significant difference in the detection rate of canceration among tubular adenoma, villous-tubular adenoma and villous adenoma in the advanced group (χ²=3.002, P=0.249). Conclusions At present, colorectal adenomatous polyps should be paid attention to. Endoscopic physicians should master the clinical and pathological characteristics of advanced colorectal adenomatous polyps, in order to raise the detection efficiency of advanced adenoma polyps and cancerous cases.

Citation： HUANG Zhong, ZHANG Jie, CHENG Fang, HOU Cong, CHEN Xinlian. The clinical and pathological characteristics of advanced colorectal adenomatous polyps. West China Medical Journal, 2021, 36(12): 1700-1704. doi: 10.7507/1002-0179.201912241 Copy

1.	王巧云, 章禮久, 宋莎莎. 結直腸息肉、結直腸癌的特點及與幽門螺桿菌感染相關性的研究. 胃腸病學和肝病學雜志, 2021, 30(4): 405-410.
2.	Jemal A, Bray F, Center MM, et al. Global cancer statisties. CA Cancer J Clin, 2011, 61(2): 69-90.
3.	Winawer SJ, Zauber AG, Fletcher RH, et al. Guidelines for colonoscopy surveillance after polypectomy: a consensus update by the US multi-society task force on colorectal cancer and the American Cancer Society. Gastroenterol, 2006, 130(6): 1872-1885.
4.	楊雪, 李貞茂, 李易, 等. 大腸腺瘤性息肉的特點及與癌變關系的探討. 西部醫學, 2010, 22(12): 2223-2225.
5.	康海鋒, 李海燕, 朱凌音, 等. 結腸進展期腺瘤的內鏡下檢出特點. 中華消化內鏡雜志, 2014, 31(9): 542-544.
6.	李清鋒, 劉兆周, 丘文丹, 等. 大腸癌精篩中內鏡黏膜切除術對結直腸進展期腺瘤的診治價值. 中國臨床新醫學, 2018, 11(10): 978-981.
7.	張進文, 譚少華, 徐義祥, 等. 結腸鏡篩查 203 例無癥狀人群結直腸癌及腺瘤檢出率分析. 中華結直腸疾病電子雜志, 2014, 3(6): 37-41.
8.	王艷麗, 雷徽, 王川, 等. 重慶地區平均風險人群結直腸腺瘤檢出情況及危險因素分析. 檢驗醫學與臨床, 2018, 15(20): 3033-3036, 3040.
9.	Atkin WS, Saunders BP, British Society for Gastroenterology, et al. Surveillance guidelines after removal of colorectal adenomatous polyps. Gut, 2002, 51(Suppl 5): V6-V9.
10.	Nguyen SP, Bent S, Chen YH, et al. Gencler as a risk factor for advanced neoplasia and colorectal cancer: a systematic review and meta-analysis. Clin Gastroenterol Hepatol, 2009, 7(6): 676-681.e1-e3.
11.	翟愛軍, 陳洪, 張續乾, 等. 結直腸進展期腺瘤危險因素分析. 中華保健醫學雜志, 2018, 20(2): 102-104.
12.	胡煦晨, 楊雪松, 劉艷霞, 等. 結直腸腺瘤 382 例癌變相關危險因素分析. 中華消化雜志, 2016, 36(4): 271-274.
13.	曹泮懸, 沈永洲, 黃彥欽, 等. 結直腸癌篩查發現的 7408 例腸道病變臨床特征及病理類型分析. 中華消化內鏡雜志, 2018, 35(9): 630-633.
14.	黃玉蓮, 張玫. 結直腸高危腺瘤的危險因素分析. 山西醫科大學學報, 2011, 42(8): 682-684.
15.	Diamond SJ, Enestvedt BK, Jiang Z, et al. Adenoma detection rate increases with each decade of life after 50 years of age. Gastrointest Endosc, 2011, 74(1): 135-140.
16.	李紅平, 周光群, 劉雪梅, 等. 內鏡黏膜下剝離術治療老年人大腸側向發育型腫瘤的初步研究. 中國內鏡雜志, 2018, 24(11): 56-61.
17.	張寒仙, 黃春梅, 彭鐵立, 等. 結直腸多發息肉臨床特點及癌變率分析. 中國現代醫藥雜志, 2018, 20(12): 17-19.
18.	Citarda F, Tomaselli G, Capocaccia R, et al. Efficacy in standard clinical practice of colonoscopic polypectomy in reducing colorectal cancer incidence. Gut, 2001, 48(6): 812-815.
19.	楊利青, 陳言東. 大腸息肉與上皮內瘤變的內鏡表現與病理特點的相關研究進展. 包頭醫學院學報, 2013, 29(5): 132-134.
20.	Arebi N, Swain D, Suzuki N, et al. Endoscopic mucosal resection of 161 cases of large sessile or flat colorectal polyps. Scand J Gastroenterol, 2007, 42(7): 859-866.
21.	Lieberman D, Moravec M, Holub J, et al. Polyp size and advanced histologs in patients undergoing colonoscopy screening: implication for CT colonography. Gastroenterol, 2008, 135(4): 1100-1105.

1. 王巧云, 章禮久, 宋莎莎. 結直腸息肉、結直腸癌的特點及與幽門螺桿菌感染相關性的研究. 胃腸病學和肝病學雜志, 2021, 30(4): 405-410.
2. Jemal A, Bray F, Center MM, et al. Global cancer statisties. CA Cancer J Clin, 2011, 61(2): 69-90.
3. Winawer SJ, Zauber AG, Fletcher RH, et al. Guidelines for colonoscopy surveillance after polypectomy: a consensus update by the US multi-society task force on colorectal cancer and the American Cancer Society. Gastroenterol, 2006, 130(6): 1872-1885.
4. 楊雪, 李貞茂, 李易, 等. 大腸腺瘤性息肉的特點及與癌變關系的探討. 西部醫學, 2010, 22(12): 2223-2225.
5. 康海鋒, 李海燕, 朱凌音, 等. 結腸進展期腺瘤的內鏡下檢出特點. 中華消化內鏡雜志, 2014, 31(9): 542-544.
6. 李清鋒, 劉兆周, 丘文丹, 等. 大腸癌精篩中內鏡黏膜切除術對結直腸進展期腺瘤的診治價值. 中國臨床新醫學, 2018, 11(10): 978-981.
7. 張進文, 譚少華, 徐義祥, 等. 結腸鏡篩查 203 例無癥狀人群結直腸癌及腺瘤檢出率分析. 中華結直腸疾病電子雜志, 2014, 3(6): 37-41.
8. 王艷麗, 雷徽, 王川, 等. 重慶地區平均風險人群結直腸腺瘤檢出情況及危險因素分析. 檢驗醫學與臨床, 2018, 15(20): 3033-3036, 3040.
9. Atkin WS, Saunders BP, British Society for Gastroenterology, et al. Surveillance guidelines after removal of colorectal adenomatous polyps. Gut, 2002, 51(Suppl 5): V6-V9.
10. Nguyen SP, Bent S, Chen YH, et al. Gencler as a risk factor for advanced neoplasia and colorectal cancer: a systematic review and meta-analysis. Clin Gastroenterol Hepatol, 2009, 7(6): 676-681.e1-e3.
11. 翟愛軍, 陳洪, 張續乾, 等. 結直腸進展期腺瘤危險因素分析. 中華保健醫學雜志, 2018, 20(2): 102-104.
12. 胡煦晨, 楊雪松, 劉艷霞, 等. 結直腸腺瘤 382 例癌變相關危險因素分析. 中華消化雜志, 2016, 36(4): 271-274.
13. 曹泮懸, 沈永洲, 黃彥欽, 等. 結直腸癌篩查發現的 7408 例腸道病變臨床特征及病理類型分析. 中華消化內鏡雜志, 2018, 35(9): 630-633.
14. 黃玉蓮, 張玫. 結直腸高危腺瘤的危險因素分析. 山西醫科大學學報, 2011, 42(8): 682-684.
15. Diamond SJ, Enestvedt BK, Jiang Z, et al. Adenoma detection rate increases with each decade of life after 50 years of age. Gastrointest Endosc, 2011, 74(1): 135-140.
16. 李紅平, 周光群, 劉雪梅, 等. 內鏡黏膜下剝離術治療老年人大腸側向發育型腫瘤的初步研究. 中國內鏡雜志, 2018, 24(11): 56-61.
17. 張寒仙, 黃春梅, 彭鐵立, 等. 結直腸多發息肉臨床特點及癌變率分析. 中國現代醫藥雜志, 2018, 20(12): 17-19.
18. Citarda F, Tomaselli G, Capocaccia R, et al. Efficacy in standard clinical practice of colonoscopic polypectomy in reducing colorectal cancer incidence. Gut, 2001, 48(6): 812-815.
19. 楊利青, 陳言東. 大腸息肉與上皮內瘤變的內鏡表現與病理特點的相關研究進展. 包頭醫學院學報, 2013, 29(5): 132-134.
20. Arebi N, Swain D, Suzuki N, et al. Endoscopic mucosal resection of 161 cases of large sessile or flat colorectal polyps. Scand J Gastroenterol, 2007, 42(7): 859-866.
21. Lieberman D, Moravec M, Holub J, et al. Polyp size and advanced histologs in patients undergoing colonoscopy screening: implication for CT colonography. Gastroenterol, 2008, 135(4): 1100-1105.

West China Medical Journal

The clinical and pathological characteristics of advanced colorectal adenomatous polyps

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