CAJ | 학술논문

目的：探讨大肠息肉癌变的相关危险因素。方法收集该院2003～2012年行结肠镜检查的患者资料，对经病理证实为大肠息肉患者的性别、年龄、息肉的单发或多发情况、部位、大小、病理类型与癌变的关系进行分析总结。结果2003～2012年间行肠镜检查共75084例，检出息肉14806例，检出率为19．72％。左半和右半大肠息肉的检出率在不同年龄段人群中差异有统计学意义（P＜0．05），但全结肠息肉的检出率随年龄的增加而增高；上皮内瘤变和癌变的发生率随患者的年龄增加而增高；左半结肠息肉癌变率明显高于右半结肠（ P＜0．0167）；息肉癌变率随其直径的增大而增高（ P＜0．01）；各类腺瘤性息肉的癌变率均高于增生性息肉，息肉的绒毛成分愈多癌变率越高（P＜0．01）。结论患者年龄、息肉的部位、大小和组织学类型是预测癌变危险性的重要指标，对年龄大于45岁、直径大于或等于1 cm ，特别是左半腺瘤性息肉应尽早行内镜下治疗，以防止大肠癌的发生。
목적：탐토대장식육암변적상관위험인소。방법수집해원2003～2012년행결장경검사적환자자료，대경병리증실위대장식육환자적성별、년령、식육적단발혹다발정황、부위、대소、병리류형여암변적관계진행분석총결。결과2003～2012년간행장경검사공75084례，검출식육14806례，검출솔위19．72％。좌반화우반대장식육적검출솔재불동년령단인군중차이유통계학의의（P＜0．05），단전결장식육적검출솔수년령적증가이증고；상피내류변화암변적발생솔수환자적년령증가이증고；좌반결장식육암변솔명현고우우반결장（ P＜0．0167）；식육암변솔수기직경적증대이증고（ P＜0．01）；각류선류성식육적암변솔균고우증생성식육，식육적융모성분유다암변솔월고（P＜0．01）。결론환자년령、식육적부위、대소화조직학류형시예측암변위험성적중요지표，대년령대우45세、직경대우혹등우1 cm ，특별시좌반선류성식육응진조행내경하치료，이방지대장암적발생。
Objective Colorectal polyp is a precancerous lesion of colorectal cancer .Aim of the study was to explore the risk fac-tors of colorectal polyp malignant transformation .Methods The related information of 75 084 colonoscopies performed from 2003 to 2012 in Southwest Hospital in Chongqing were collected and the relationship between polyp malignant transformation and the pa-tient age ,sex ,polyp location ,size or histological types was analyzed .Results From 2003 to 2012 ,polyps were diagnosed in 14 806 cases of the total 75 084 patients with a 19 .72% detection rate .There were significant difference of the left-side and right-side pol-yp detection rate in different age groups ,and the frequency of polyps distributed in the whole colorectum increased with the increase of age .The rates of epithelial neoplasia and malignant transformation increased with age .At the same time ,malignant transforma-tion rate was significant higher in polyps located in left-side than that in right-side (P<0 .0167) ,in adenoma than that in inflamma-tory hyperplastic polyp (P<0 .01) .The larger diameter and the more villus ,the higher rate of malignant transformation .Conclusion Patient age ,polyp size ,location and histological type could be considered as the significant predictors of colorectal polyp malignant transformation .It may be useful to treat the polyp with endoscopy in patient with age more than 45 and adenoma whose diameter was not less than 1 cm ,located in left-side for prevention of colorectal cancer .