摘要
目的:探讨直径≥20 mm结直肠侧向发育型肿瘤(LST)的内镜病理特征。方法:收集结直肠LST患者212例,根据病变大小分为直径≥20 mm(134例)及直径<20 mm(78例)两组,对比分析两组的病变部位、内镜下外观形态及腺管开口(Pit pattern)分型及组织病理类型。结果:直径≥20 mm组女性患者比例高于直径<20 mm组(P<0.05),两组患者的LST均好发于升结肠,直径≥20 mm组发生在直肠的比例高于直径<20 mm组(P<0.05);直径≥20 mm组外观形态以LST-G-M为主,且占比高于直径<20 mm组(P<0.05);两组Pit pattern分型均以混合型为主,直径≥20 mm组发生混合型患者比例高于直径<20 mm组(P<0.05);直径≥20 mm患者治疗方式以ESD及外科手术为主,而直径<20 mm组患者以EMR及ESD为主;直径≥20 mm组高级别上皮内瘤变及浸润癌的比例远高于直径<20 mm组(P<0.05)。结论:LST直径≥20 mm时好发于直肠、升结肠,外观形态以LST-G-M为主,且恶变潜能更高。
Objective:To investigate the endoscopic pathological characteristics of colorectal laterally developmental tumors(LST)with a diameter larger than 20 mm.Methods:212 cases of colorectal LST lesions were collected and divided into two groups with a diameter≥20 mm(134 cases)and a diameter<20 mm(78 cases).The lesions,appearance and morphology,Pit pattern classification,and histopathological types of two groups were compared and analyzed.Results:The proportion of female patients in the group with diameter≥20 mm was higher than that in the group with diameter<20 mm(P<0.05).The incidence of LST in both groups was more likely to occur in the ascending colon,and the incidence of LST in the group with diameter≥20 mm was higher than that in the group with diameter<20 mm(P<0.05).LST-G-M was dominant in the group with diameter≥20 mm,and the proportion was higher than that in the group with diameter<20 mm(P<0.05).The Pit pattern was mainly mixed in both groups,and the proportion of mixed patients in the group with diameter≥20 mm was higher than that in the group with diameter<20 mm(P<0.05).Patients with diameter≥20 mm were mainly treated with ESD and surgery while patients with diameter<20 mm were mainly treated with EMR and ESD.The proportion of high-grade intraepithelial neoplasia and infiltrating carcinoma in the≥20 mm group was significantly higher than that in the<20 mm group(P<0.05).Conclusion:LST is more common in the rectum and ascending colon when the diameter of it is≥20 mm.The appearance is dominated by LST-G-M and the potential for malignant transformation is higher than that in the group with diameter<20 mm.Size is one of the risks of canceration and a key factor in determining the treatment.
作者
李大欢
邓超男
徐晓雯
张维森
吴玉婷
刘娅琳
陈万伟
LI Dahuan;DENG Chaonan;XU Xiaowen;ZHANG Weiseng;WU Yuting;LIU Yalin;CHEN Wanwei(Department of Internal Medicine,School of Clinical Medicine,Guizhou Medical University,Guiyang 550004,Guizhou,China;Department of Pathology,School of Basic Medicine,Guizhou Medical University,Guiyang 550004,Guizhou,China)
出处
《贵州医科大学学报》
CAS
2020年第8期954-958,共5页
Journal of Guizhou Medical University
基金
贵州省教育厅青年科技人才成长项目[黔教合KY字(2018)178]。
关键词
结直肠肿瘤
形态分型
病理特征
内镜
手术治疗
侧向发育型肿瘤
colorectal neoplasms
morphology
pathological characteristics
endoscopy
surgical treatment
lateral spreading tumor(LST)
