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, 章礼久, 宋莎莎. 结直肠息肉、结直肠癌的特点及与幽门螺杆菌感染相关性的研究. 胃肠病学和肝病学杂志, 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.	杨雪, 李贞茂, 李易, 等. 大肠腺瘤性息肉的特点及与癌变关系的探讨. 西部医学, 2010, 22(12): 2223-2225.
5.	康海锋, 李海燕, 朱凌音, 等. 结肠进展期腺瘤的内镜下检出特点. 中华消化内镜杂志, 2014, 31(9): 542-544.
6.	李清锋, 刘兆周, 丘文丹, 等. 大肠癌精筛中内镜黏膜切除术对结直肠进展期腺瘤的诊治价值. 中国临床新医学, 2018, 11(10): 978-981.
7.	张进文, 谭少华, 徐义祥, 等. 结肠镜筛查 203 例无症状人群结直肠癌及腺瘤检出率分析. 中华结直肠疾病电子杂志, 2014, 3(6): 37-41.
8.	王艳丽, 雷徽, 王川, 等. 重庆地区平均风险人群结直肠腺瘤检出情况及危险因素分析. 检验医学与临床, 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.	翟爱军, 陈洪, 张续乾, 等. 结直肠进展期腺瘤危险因素分析. 中华保健医学杂志, 2018, 20(2): 102-104.
12.	胡煦晨, 杨雪松, 刘艳霞, 等. 结直肠腺瘤 382 例癌变相关危险因素分析. 中华消化杂志, 2016, 36(4): 271-274.
13.	曹泮悬, 沈永洲, 黄彦钦, 等. 结直肠癌筛查发现的 7408 例肠道病变临床特征及病理类型分析. 中华消化内镜杂志, 2018, 35(9): 630-633.
14.	黄玉莲, 张玫. 结直肠高危腺瘤的危险因素分析. 山西医科大学学报, 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.	李红平, 周光群, 刘雪梅, 等. 内镜黏膜下剥离术治疗老年人大肠侧向发育型肿瘤的初步研究. 中国内镜杂志, 2018, 24(11): 56-61.
17.	张寒仙, 黄春梅, 彭铁立, 等. 结直肠多发息肉临床特点及癌变率分析. 中国现代医药杂志, 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.	杨利青, 陈言东. 大肠息肉与上皮内瘤变的内镜表现与病理特点的相关研究进展. 包头医学院学报, 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, 章礼久, 宋莎莎. 结直肠息肉、结直肠癌的特点及与幽门螺杆菌感染相关性的研究. 胃肠病学和肝病学杂志, 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. 杨雪, 李贞茂, 李易, 等. 大肠腺瘤性息肉的特点及与癌变关系的探讨. 西部医学, 2010, 22(12): 2223-2225.
5. 康海锋, 李海燕, 朱凌音, 等. 结肠进展期腺瘤的内镜下检出特点. 中华消化内镜杂志, 2014, 31(9): 542-544.
6. 李清锋, 刘兆周, 丘文丹, 等. 大肠癌精筛中内镜黏膜切除术对结直肠进展期腺瘤的诊治价值. 中国临床新医学, 2018, 11(10): 978-981.
7. 张进文, 谭少华, 徐义祥, 等. 结肠镜筛查 203 例无症状人群结直肠癌及腺瘤检出率分析. 中华结直肠疾病电子杂志, 2014, 3(6): 37-41.
8. 王艳丽, 雷徽, 王川, 等. 重庆地区平均风险人群结直肠腺瘤检出情况及危险因素分析. 检验医学与临床, 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. 翟爱军, 陈洪, 张续乾, 等. 结直肠进展期腺瘤危险因素分析. 中华保健医学杂志, 2018, 20(2): 102-104.
12. 胡煦晨, 杨雪松, 刘艳霞, 等. 结直肠腺瘤 382 例癌变相关危险因素分析. 中华消化杂志, 2016, 36(4): 271-274.
13. 曹泮悬, 沈永洲, 黄彦钦, 等. 结直肠癌筛查发现的 7408 例肠道病变临床特征及病理类型分析. 中华消化内镜杂志, 2018, 35(9): 630-633.
14. 黄玉莲, 张玫. 结直肠高危腺瘤的危险因素分析. 山西医科大学学报, 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. 李红平, 周光群, 刘雪梅, 等. 内镜黏膜下剥离术治疗老年人大肠侧向发育型肿瘤的初步研究. 中国内镜杂志, 2018, 24(11): 56-61.
17. 张寒仙, 黄春梅, 彭铁立, 等. 结直肠多发息肉临床特点及癌变率分析. 中国现代医药杂志, 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. 杨利青, 陈言东. 大肠息肉与上皮内瘤变的内镜表现与病理特点的相关研究进展. 包头医学院学报, 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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