大肠息肉癌变的内镜诊断及病理分析

目的：分析大肠息肉癌变的分布、大小、形态、病理特征及寻求息肉癌变的早期诊断、防治的方法。方法：回顾性分析经内镜诊断的68例（71个）大肠息内癌变的内镜、病理与临床资料。结果：1660例（2540个）大肠息肉中有68例（71个）癌变，癌变率为4．10％，左半结肠息肉癌变69个，占息肉癌变总数的97.18%。绒毛状腺瘤、混合腺瘤癌变率较高（分别为56．76％、14．71％），管状腺瘤癌变率较低（为4．17％）。息肉直径＞2.0cm者癌变率为37.40%，息肉直径1.0-2.0cm者癌变率为4.64%，息肉直径＜1cm者癌变率为0.43%，息肉直径＞2.0cm者癌变率明显高于2.0cm以下者。广基息肉癌变率10.08%。结论：左半结肠息肉、宽基息肉、直径＞2.0cm息肉、绒毛状腺瘤容易癌变。大肠息肉不论大小应尽可能予以切除，全瘤送检。内镜切除大肠息肉可预防息肉癌变。

Endoscopy and pathological analysis of polypous canceration in large intestine

Objective:To seek after early diangnostic and preventive methods for polypous canceration in large intestine.Methods:The clinico pathological data in 68 patients with polypous canceration in large intestine diagnosed by endoscopy were retrospectively analysed.Results:Of 1660 patients(2540 polyps),68 cases(4.1%)were found to have polypous canceration(71 malignant polyps).The frequency of malignant polyps in left colon was 97.18%(69/71).The canceration rates in villous,mixed and tubular adenomas were 56.76%,14.71% and 4.17%,respectively.The canceration incidences in polyps with broad pedicles and 2cm or more in diameter were higher than those with narrow pedicles and 2cm or less in diameter.Conclusion:There is a high canceration of polyps in left colon and villous adenomas.The broader the pedicles and the larger the diameters of polyps are,the higher the malignant rates could be.All of the colon polyps should be excised and undergone pathological examination as far as possible.Endoscopic resection of polyp is helpful in the prevention of canceration of colon polyps.