目的 分析Peutz-Jeghers综合征临床特点，以提高诊治水平。 方法 2008年11月-2010年1月对8例Peutz-Jeghers综合征的临床资料进行回顾性分析。 结果 男女各4例，年龄13～41岁，病程20 d～40年。8例均有黑斑和息肉，5例有明确的家族史。首发表现以腹痛为主，轻度抑郁表现2例，并发肠套叠2例，结肠癌1例。病理报告：错构瘤4例。外科手术治疗1例，结肠镜治疗6例，保守治疗1例。 结论 Peutz-Jeghers综合征易并发抑郁症、肠套叠和恶性肿瘤，患者需心理治疗和遗传咨询，肠镜下息肉切除是主要手段。
The results of 2389 patients exmained by colonofiverscope in past nine years are reported. Polyps were found in 561 cases, including 1256 polyps in the large intestine and 82 polyps in the terminal ileum. All 1299 polyps were removed with biopsy forceps. Pathology demonstrated that there were 406 adenomas, including 89 atypical hyperplasia and 23 cases with malignant change and 932 non-canerous polyps with 102 atypical hyperplasia. Since adenoma is seen to be a precancerous change, the polypectomy by colonofiberscope , ecpecially atypical hyperplastic polyps may decrease morbidity of large intestinal cancer. Cancer associated with adenoma may be as high as 51.28%, so the recrudescence of polyps may possibly be found even afer the cancer removal. These data showed that an early discovery of small malignant adenoma is key to improve efficiency.
With the development and popularization of imaging technology, the discovery of gallbladder lesions has become common, among which non-neoplastic lesions (such as gallbladder stones, cholecystitis, gallbladder polyps, gallbladder adenomyosis, etc.) are common but sometimes the imaging manifestations are not specific, and there are many kinds of such diseases, so accurate imaging diagnosis is still quite challenging. Familiarity and understanding of the typical imaging manifestations of these diseases will help to improve the early and accurate diagnosis and help to distinguish them from gallbladder malignant diseases, which is of great significance to the diagnosis, guiding treatment and prognosis of patients.
ObjectiveTo investigate the relation between colonic adenomatous polyps and Helicobacter pylori infection. MethodsA case-control study was conducted to collect clinical data of patients with colonic adenomatous polyps in People's Hospital of Zhongjiang County from February 2014 to September 2015. Patients with healthy colon of the corresponding period of the hospital were collected as a control group. The difference of positive rate of Hp infection was compared between the colonic adenomatous polyps group and the control group. According to the age, gender, living condition, location, type of pedicle, pathological type and number, the colonic adenomatous polyps group was divided into subgroups and the differences of positive rate of Hp infection were compared among the subgroups. ResultsA total of 219 patients involving 119 cases and 100 controls were included. The positive rate of Hp infection in the colonic adenomatous polyps group was significantly higher than that in the control group (69.7% vs. 52.0%) with a significant difference (χ2=7.239, P=0.007). Among 119 patients with colonic adenomatous polyps, no statistical differences were found in the positive rate of Hp infection among subgroups of different age, gender, living condition, location, type of pedicle, pathological type and number (all P values>0.05). ConclusionHp infection may increase the risk of developing colonic adenomatous polyps.
In order to address the issues of spatial induction bias and lack of effective representation of global contextual information in colon polyp image segmentation, which lead to the loss of edge details and mis-segmentation of lesion areas, a colon polyp segmentation method that combines Transformer and cross-level phase-awareness is proposed. The method started from the perspective of global feature transformation, and used a hierarchical Transformer encoder to extract semantic information and spatial details of lesion areas layer by layer. Secondly, a phase-aware fusion module (PAFM) was designed to capture cross-level interaction information and effectively aggregate multi-scale contextual information. Thirdly, a position oriented functional module (POF) was designed to effectively integrate global and local feature information, fill in semantic gaps, and suppress background noise. Fourthly, a residual axis reverse attention module (RA-IA) was used to improve the network’s ability to recognize edge pixels. The proposed method was experimentally tested on public datasets CVC-ClinicDB, Kvasir, CVC-ColonDB, and EITS, with Dice similarity coefficients of 94.04%, 92.04%, 80.78%, and 76.80%, respectively, and mean intersection over union of 89.31%, 86.81%, 73.55%, and 69.10%, respectively. The simulation experimental results show that the proposed method can effectively segment colon polyp images, providing a new window for the diagnosis of colon polyps.
Objective To analyze the clinical pathological features of patients with hereditary nonpolyposis colorectal cancer （HNPCC） in northeast Chinese. Methods The clinical data of 101 probands （HNPCC group） from 1982 to 2011 in the Fourth Affiliated Hospital of China Medical University and Tumor hospital of Liaoning Province and 272 patients with sporadic colorectal cancer （sporadic CRC group） in the same period were collected. The clinicopathologic features were compared in two groups. Results In the HNPCC group， the age of onset was younger than 45 years old in 24 patients （23.8%）， proximal colon in 31 （30.7%）， multiple primary carcinomas in 26 （25.7%）， extracolonic carcinoma in 13 （12.9%）， mucinous adenocarcinoma in 32 （31.7%）， phaseⅠandⅡin 68 （67.3%）， high-middle differentiation in 70 （69.3%）， and lymph node metastasis in 33 （32.7%）， while in the sporadic CRC group were 12 （4.4%）， 54 （19.9%）， 15 （5.5%）， 11 （4.0%）， 30 （11.0%）， 127 （46.7%）， 152 （55.9%）， and 140 （51.5%）， respectively. There were significant differences between the HNPCC group and the sporadic CRC group （P＜0.05）. Meanwhile， extracolonic carcinomas in the HNPCC group were endometrial cancer in 3， bladder cancer in 3， breast cancer in 2， brain tumor in 2， ovarian cancer in 1， gastric cancer in 1， and lung cancer in 1. Conclusions Northeast China HNPCC patients with several particular clinicopathologic features such as early onset， frequent localization in proximal colon， proclivity of synchronous and metachronous tumors， excessive mucinous adenocarcinoma， less poorly differentiated tumors， lymph node metastasis， early stage of tumor， and so on. Therefore， clinicopathologic feature is still a preferred method of diagnosis of HNPCC patients or suspected HNPCC patients.
bjective To study the change of mucins of expression in lithic cholecystitis and cholecystic adenomatiod polyps. MethodsMUC1 and MUC3 were detected in the mucosa of human normal gallbladders (20 cases, control group), of calcareous cholecystitis (38 cases, calcareous group) and of adenomatoid polyps (18 cases, polyp group) with immunohistochemical stains and Western blotting methods. ResultsThe positive rate and optical density values of MUC1 were increased significantly in calcareous and polyp group vs control group (P＜0.01), otherwise, MUC3 was decreased markedly (P＜0.01). Conclusion The expressions of MUC1, MUC3 were not synchronization in different lesions of cholecyst.