结直肠息肉癌变的内镜下表现、治疗及癌变因素分析

目的探讨结直肠息肉癌变的内镜下表现，分析癌变相关因素和治疗策略。方法回顾性分析经电子结肠镜检查或治疗的77例结直肠癌变息肉患者的临床、内镜及病理资料，探讨影响结直肠息肉癌变的相关因素及其内镜下治疗策略。结果77例癌变结直肠息肉中，9例伴发结肠癌。60例有临床症状，症状发生率为77．9％（60／77）。息肉癌变主要分布在乙状结肠，多发生于年龄超过60岁的老年患者，绒毛状腺瘤癌变率最高。行电子结肠镜电切法切除44例，其中完全切除38例。结论年龄〉60岁患者和乙状结肠息肉癌变发生率明显增高，选择性对属于原位癌或早期浸润癌的癌变息肉行电子结肠镜下切除是安全有效的。

Malignant colorectal polyps: endoscopic features, therapy and high risk factors

Objective Endoscopic features, canceration factors and treatment methods for malignant colorectal polyps were investigated. Methods The documents of 77 patients with malignant colorectal polyps detected by video colonoscopy were retrospectively reviewed and analyzed. The features of malignant colorectal polyps including the location, size, morphology and histopathology were investigated. Results Most polyps were located in the left-sided colon. Malignant colorectal polyps and coexisting carcinoma were adenomatous polyps in 95%(73 of 77) of patients. There was a higher canceration rate for these patients more than 60 years old, and /or with sigmoid polyps(P﹤0.05). Polypectomies were successfully operated in 38 out of 44 cases of malignant colorectal polyps. Conclusion The patients more than 60 years old, and/ or with sigmoid polyps should be treated and followed up actively. Small malignant colorectal polyps belonging to early stages could be effectively resected colonoscopilly.