结直肠锯齿状腺瘤52例临床、内镜及病理特点分析

张浩; 田怡; 陈永其; 冯莉; 谢蕴; 陈世耀

留言板

尊敬的读者、作者、审稿人, 关于本刊的投稿、审稿、编辑和出版的任何问题, 您可以本页添加留言。我们将尽快给您答复。谢谢您的支持!

姓名
邮箱
手机号码
标题
留言内容
验证码

结直肠锯齿状腺瘤52例临床、内镜及病理特点分析

张浩 , 田怡 , 陈永其 , 冯莉 , 谢蕴 , 陈世耀

文章导航 > 蚌埠医学院学报 > 2012, 36 > 11: (1294-1295,1297)

引用本文:

Citation:

结直肠锯齿状腺瘤52例临床、内镜及病理特点分析

1.
1. 复旦大学附属中山医院消化内科, 上海 200032;
2.
2. 上海医药高等专科学校附属闵行区中心医院消化内科, 上海 201199

作者简介: 张浩(1977- ), 女, 主治医师.

通讯作者: 陈世耀, syaochen@163.com

基金项目:

Analysis of the endoscopic and pathologic characteristics of 52 cases with the serrated adenoma of large intestine

1.
1. Department of Digestion Internal Medicine, Zhongshan Hospital Affiliated to Fudan University, Shanghai 200032;
2.
2. Department of Digestion Internal Medicine, Minhang District Central Hospital Affiliated to Shanghai Institute of Health Sciences, Shanghai 201199, China

Corresponding author: CHEN Shi-yao, syaochen@163.com

摘要: 目的:探讨结直肠锯齿状腺瘤患者的临床、内镜及病理特点。方法:对52例结直肠锯齿状腺瘤的临床、内镜及病理特点进行回顾分析。结果:病变位于直肠19例, 位于乙状结肠13例, 位于直肠乙状结肠交界处2例, 位于降结肠6例, 位于横结肠8例, 位于升结肠3例, 盲肠1例;多发1例, 单发51例;腺瘤直径1～25 mm。52例中广基息肉32例, 亚蒂息肉15例, 有蒂息肉5例。病理学检查为单纯锯齿状腺瘤17例, 锯齿状腺瘤伴低级别上皮内瘤变33例, 锯齿状腺瘤伴局部高级别上皮内瘤变1例, 锯齿状腺瘤局部恶变1例。结论:结直肠锯齿状腺瘤临床症状无特异, 以单发广基息肉多见, 多见于直肠, 常伴上皮内瘤变。
- 结直肠肿瘤 /
- 结肠镜 /
- 病理特点
Abstract: Objective: To investigate the endoscopic and pathologic characteristics of 52 cases with the serrated adenoma of large intestine. Methods: The endoscopic and pathologic characteristics of 52 cases with the serrated adenoma of large intestine were retrospectively analysed. Results: Among 52 cases with serrated adenoma, there were 19 cases in rectum, 13 cases in sigmoid colon, 2 cases in the junction of rectum and sigmoid colon, 6 cases in descending colon, 8 cases in transverse colon, 3 cases in ascending colon and 1 case in cecum. One case with multiple adenoma and 51 cases with single adenoma were found, which diameters were 1 to 25 mm. Fifty-five cases with serrated adenoma included 32 cases with wide base polyps, 15 cases with sub-pedicle polyps and 5 cases with pedicle polyps. The pathologic examination showed 17 cases with pure serrated adenoma, 33 cases with serrated adenoma complicated with low grade intraepithelial neoplasia, 1 case with serrated adenoma complicated with high grade intraepithelial neoplasia and 1 case with local malignant of serrated adenoma. Conclusions: The clinical symptoms of serrated adenoma are non-specificity, the single and wide base polyps complicated with intraepithelial neoplasia are most, located in rectum.
- colorectal neoplasms /
- colonoscope /
- pathologic characteristics

[2] .Hawkins NJ,Bariol C,Ward RL.The serrated neoplasis pathway[J].Pathology,2002,34(6):548-555.
[2]	.Kambara T,Simmsl A,Whitehall VL,et al.BRA mutation is associated with DNA methylation in serrated polyps and cancers of the colorectum[J].Gut,2004,53(8):1137-1144.
[3] .刘运祥,黄留业.实用消化内镜治疗学[M].北京:人民卫生出版社,2002:151.
[4] .刘思德,岳萍,李明松,等.罕见大肠平坦型病变并锯齿状腺瘤工作报道[J].解放军医学杂志,2004,29(8):941-942.
[5] .Goldman H,Ming S,Hickok DF.Nature and significance of hyperplastic polyps of the human colon[J].Arch Pathol,1970,89(4):349-354.
[6] .Longacre TA,Fenglio-Preiser CM.Mixed hyperplastic adenomatous polyps/serrated adenomas.A distinct form of colorectal neoplasia[J].Am J Surg Pathol,1990,14(6):524-537.
[7] .Jaramillo E,Watanabe M,Rubio C,et al.Small colorectal serrated adenomas:endoscopic findings[J].Endoscopy,1997,29(1):1-3.
[8] .张婉雯,任宝军,姜泊,等.结直肠锯齿状腺瘤的内镜与病理形态特征分析[J].中华消化内镜杂志,2006,23(2):81-85.
[9] .Kasumi A,Kratzer GL,Takeda M.Observations of aggressive,small,flat,and depressed colon cancer.Report of three cases[J].Surg Endosc,1995,9(6):690-694.
[10] .Ball CG,Dupre MP,Falck V,et al.Sessile serrated polypmimicry in patients withsolitary rectal ulcer syndrome:is there evidence of preneoplastic change[J].Arch pathol Lab Med,2005,129(8):1037-1040.
[11] .Shia J,Ellis NA,Paty PB,et al.Value of histopathology in predicting microsatellite instability inhereditary nonpolyposis colorectal cancer colorectal cancer[J].Am J Surg Pathol,2003,27(11):1407-1417.
[12] .O'Brien MJ,Yang S,Mack C,et al.Comparison of microsatellite instability,CpG island methylation phenotype,BRAF and KRAS status in serrated polyps and traditional adenomas indicates separate pathways to distinct colorectal carcinoma end points[J].Am J Surg Pathol,2006,30(12):1491-1501.
[13] .周智勇,韩英,王志红.结肠锯齿状病变BRAF 基因变异的研究[J].中华医学杂志,2008,88(18):3411.

[1]	高小芳 . 腹腔镜联合结肠镜治疗结直肠肿瘤23例护理体会. 蚌埠医学院学报, 2012, 36(12): 1538-1539.
[2]	张成斌 , 周少波 , 邵明 , 郑兆炜 , 闻静 . 色素内镜联合肿瘤标志物检测在早期结直肠癌诊断中的应用. 蚌埠医学院学报, 2018, 43(1): 23-26. doi: 10.13898/j.cnki.issn.1000-2200.2018.01.007
[3]	江淮芝 , 姚爱群 , 何淑燕 . 两种肠道准备方法在结肠镜检查前应用效果比较. 蚌埠医学院学报, 2010, 35(11): 1173-1174.
[4]	易蓉 . PRC2成分SUZ12在结直肠癌组织中的表达及其与临床病理特征的相关性. 蚌埠医学院学报, 2016, 41(8): 1050-1052. doi: 10.13898/j.cnki.issn.1000-2200.2016.08.023
[5]	孙发缔 , 张杰 , 褚亮 . 快速康复外科在老年人腹腔镜结直肠癌手术围手术期的应用. 蚌埠医学院学报, 2018, 43(1): 49-51,55. doi: 10.13898/j.cnki.issn.1000-2200.2018.01.015
[6]	宣冬生 , 郑立东 . TEE指导GDFT联合小剂量去甲肾上腺素用于老年腹腔镜结直肠癌手术的临床观察. 蚌埠医学院学报, 2019, 44(5): 585-589. doi: 10.13898/j.cnki.issn.1000-2200.2019.05.006
[7]	戚仁华 , 张宏 , 杨正荣 , 李建军 , 陈运超 , 吴松 . 腹腔镜结直肠癌手术48例临床分析. 蚌埠医学院学报, 2013, 37(8): 953-955.
[8]	余水岸 , 周桑玉 , 黄智敏 . 俯卧位结肠镜检查在肥胖病人中的应用效果观察. 蚌埠医学院学报, 2020, 45(8): 1080-1081. doi: 10.13898/j.cnki.issn.1000-2200.2020.08.023
[9]	石红 , 陈盈 . 甲状腺乳头状癌合并桥本甲状腺炎的临床和病理特点分析. 蚌埠医学院学报, 2017, 42(3): 332-334. doi: 10.13898/j.cnki.issn.1000-2200.2017.03.015
[10]	张朋 , 胡怀强 , 曹秉振 . 强直性肌营养不良8例临床、电生理及病理特点. 蚌埠医学院学报, 2016, 41(6): 739-742,747. doi: 10.13898/j.cnki.issn.1000-2200.2016.06.011
[11]	王小明 , 余珊 , 陈欣 , 王光洁 , 孙雨欣 , 倪娜 , 张慈 . 早期结直肠癌超声内镜检查及内镜黏膜下剥离术的临床价值. 蚌埠医学院学报, 2022, 47(8): 1034-1037. doi: 10.13898/j.cnki.issn.1000-2200.2022.08.011
[12]	陈涛 . 左半结肠及直肠癌性梗阻45例治疗体会. 蚌埠医学院学报, 2006, 31(6): 652-653.
[13]	魏可 , 王文锐 , 杨清玲 , 陈昌杰 . 肿瘤相关巨噬细胞在结直肠癌发展及治疗和预后中的作用. 蚌埠医学院学报, 2023, 48(1): 31-36. doi: 10.13898/j.cnki.issn.1000-2200.2023.01.007
[14]	陈广业 , 杨清 . 肿瘤坏死因子受体相关因子4在结直肠癌中的表达及临床意义. 蚌埠医学院学报, 2022, 47(3): 322-326. doi: 10.13898/j.cnki.issn.1000-2200.2022.03.012
[15]	年峰 , 袁圆 , 王海涛 , 芦华丽 . 结直肠癌组织中BRMS1 mRNA的表达及意义. 蚌埠医学院学报, 2018, 43(5): 614-616,620. doi: 10.13898/j.cnki.issn.1000-2200.2018.05.015
[16]	杨尊敬 , 杜先玲 . 转移相关蛋白2对结直肠癌病人预后判断的价值. 蚌埠医学院学报, 2017, 42(9): 1186-1189. doi: 10.13898/j.cnki.issn.1000-2200.2017.09.010
[17]	胡世丰 , 雷春 , 施炜 , 查诚 . LncRNA-ROR抑制结直肠癌细胞转移的作用研究. 蚌埠医学院学报, 2020, 45(5): 569-571,577. doi: 10.13898/j.cnki.issn.1000-2200.2020.05.003
[18]	王书芹 , 朱广辉 . 能谱CT在结直肠癌分化程度中的应用价值研究. 蚌埠医学院学报, 2021, 46(1): 29-32. doi: 10.13898/j.cnki.issn.1000-2200.2021.01.008
[19]	丁媛媛 , 王银娥 , 周丙梅 , 霍蕊 , 孙则红 , 汪凤兰 . 结直肠癌术后肠造口病人病耻感影响因素分析. 蚌埠医学院学报, 2022, 47(6): 828-834. doi: 10.13898/j.cnki.issn.1000-2200.2022.06.030
[20]	贾建光 , 钱军肿 , 承泽农 . p33^ING1在结直肠癌中的表达及其临床意义. 蚌埠医学院学报, 2008, 33(2): 138-140,254.

点击查看大图

计量

文章访问数: 3253
HTML全文浏览量: 396
PDF下载量: 154
被引次数: 0

结直肠锯齿状腺瘤52例临床、内镜及病理特点分析

通讯作者: 陈世耀, syaochen@163.com

作者简介: 张浩(1977- ), 女, 主治医师.

1. 1. 复旦大学附属中山医院消化内科, 上海 200032;
2. 2. 上海医药高等专科学校附属闵行区中心医院消化内科, 上海 201199

收稿日期: 2012-03-19
网络出版日期: 2012-11-15

基金项目:

关键词:

摘要: 目的:探讨结直肠锯齿状腺瘤患者的临床、内镜及病理特点。方法:对52例结直肠锯齿状腺瘤的临床、内镜及病理特点进行回顾分析。结果:病变位于直肠19例, 位于乙状结肠13例, 位于直肠乙状结肠交界处2例, 位于降结肠6例, 位于横结肠8例, 位于升结肠3例, 盲肠1例;多发1例, 单发51例;腺瘤直径1～25 mm。52例中广基息肉32例, 亚蒂息肉15例, 有蒂息肉5例。病理学检查为单纯锯齿状腺瘤17例, 锯齿状腺瘤伴低级别上皮内瘤变33例, 锯齿状腺瘤伴局部高级别上皮内瘤变1例, 锯齿状腺瘤局部恶变1例。结论:结直肠锯齿状腺瘤临床症状无特异, 以单发广基息肉多见, 多见于直肠, 常伴上皮内瘤变。

English Abstract

Analysis of the endoscopic and pathologic characteristics of 52 cases with the serrated adenoma of large intestine

Corresponding author: CHEN Shi-yao, syaochen@163.com

1. 1. Department of Digestion Internal Medicine, Zhongshan Hospital Affiliated to Fudan University, Shanghai 200032;
2. 2. Department of Digestion Internal Medicine, Minhang District Central Hospital Affiliated to Shanghai Institute of Health Sciences, Shanghai 201199, China

Received Date: 2012-03-19
Available Online: 2012-11-15

Abstract: Objective: To investigate the endoscopic and pathologic characteristics of 52 cases with the serrated adenoma of large intestine. Methods: The endoscopic and pathologic characteristics of 52 cases with the serrated adenoma of large intestine were retrospectively analysed. Results: Among 52 cases with serrated adenoma, there were 19 cases in rectum, 13 cases in sigmoid colon, 2 cases in the junction of rectum and sigmoid colon, 6 cases in descending colon, 8 cases in transverse colon, 3 cases in ascending colon and 1 case in cecum. One case with multiple adenoma and 51 cases with single adenoma were found, which diameters were 1 to 25 mm. Fifty-five cases with serrated adenoma included 32 cases with wide base polyps, 15 cases with sub-pedicle polyps and 5 cases with pedicle polyps. The pathologic examination showed 17 cases with pure serrated adenoma, 33 cases with serrated adenoma complicated with low grade intraepithelial neoplasia, 1 case with serrated adenoma complicated with high grade intraepithelial neoplasia and 1 case with local malignant of serrated adenoma. Conclusions: The clinical symptoms of serrated adenoma are non-specificity, the single and wide base polyps complicated with intraepithelial neoplasia are most, located in rectum.