李大欢;邓超男;徐晓雯;张维森;吴玉婷;刘娅琳;陈万伟;
LI Dahuan;DENG Chaonan;XU Xiaowen;ZHANG Weiseng;WU Yuting;LIU Yalin;CHEN Wanwei;Department of Internal Medicine,School of Clinical Medicine,Guizhou Medical University;Department of Pathology,School of Basic Medicine,Guizhou Medical University;

• 1:贵州医科大学临床医学院内科教研室
• 2:贵州医科大学临床医学院病理教研室

摘要(Abstract)：

目的:探讨直径≥20 mm结直肠侧向发育型肿瘤(LST)的内镜病理特征。方法:收集结直肠LST患者212例,根据病变大小分为直径≥20 mm(134例)及直径<20 mm(78例)两组,对比分析两组的病变部位、内镜下外观形态及腺管开口(Pit pattern)分型及组织病理类型。结果:直径≥20 mm组女性患者比例高于直径<20 mm组(P <0.05),两组患者的LST均好发于升结肠,直径≥20 mm组发生在直肠的比例高于直径<20 mm组(P <0.05);直径≥20 mm组外观形态以LST-G-M为主,且占比高于直径<20 mm组(P <0.05);两组Pit pattern分型均以混合型为主,直径≥20 mm组发生混合型患者比例高于直径<20 mm组(P <0.05);直径≥20 mm患者治疗方式以ESD及外科手术为主,而直径<20 mm组患者以EMR及ESD为主;直径≥20 mm组高级别上皮内瘤变及浸润癌的比例远高于直径<20 mm组(P <0.05)。结论:LST直径≥20 mm时好发于直肠、升结肠,外观形态以LST-G-M为主,且恶变潜能更高。
Objective: To investigate the endoscopic pathological characteristics of colorectal laterally developmental tumors( LST) with a diameter larger than 20 mm. Methods: 212 cases of colorectal LST lesions were collected and divided into two groups with a diameter ≥20 mm( 134 cases) and a diameter < 20 mm( 78 cases). The lesions,appearance and morphology,Pit pattern classification,and histopathological types of two groups were compared and analyzed. Results: The proportion of female patients in the group with diameter ≥20 mm was higher than that in the group with diameter< 20 mm( P < 0. 05). The incidence of LST in both groups was more likely to occur in the ascending colon,and the incidence of LST in the group with diameter ≥20 mm was higher than that in the group with diameter < 20 mm( P < 0. 05). LST-G-M was dominant in the group with diameter ≥20 mm,and the proportion was higher than that in the group with diameter < 20 mm( P < 0. 05). The Pit pattern was mainly mixed in both groups,and the proportion of mixed patients in the group with diameter ≥20 mm was higher than that in the group with diameter < 20 mm( P < 0. 05). Patients with diameter ≥20 mm were mainly treated with ESD and surgery while patients with diameter< 20 mm were mainly treated with EMR and ESD. The proportion of high-grade intraepithelial neoplasia and infiltrating carcinoma in the ≥20 mm group was significantly higher than that in the <20 mm group( P < 0. 05). Conclusion: LST is more common in the rectum and ascending colon when the diameter of it is ≥20 mm. The appearance is dominated by LST-G-M and the potential for malignant transformation is higher than that in the group with diameter < 20 mm. Size is one of the risks of canceration and a key factor in determining the treatment.

关键词(KeyWords)： 结直肠肿瘤;形态分型;病理特征;内镜;手术治疗;侧向发育型肿瘤
colorectal neoplasms;morphology;pathological characteristics;endoscopy;surgical treatment;lateral spreading tumor(LST)

Abstract:

Keywords:

基金项目(Foundation): 贵州省教育厅青年科技人才成长项目[黔教合KY字(2018)178]

作者(Author): 李大欢;邓超男;徐晓雯;张维森;吴玉婷;刘娅琳;陈万伟;
LI Dahuan;DENG Chaonan;XU Xiaowen;ZHANG Weiseng;WU Yuting;LIU Yalin;CHEN Wanwei;Department of Internal Medicine,School of Clinical Medicine,Guizhou Medical University;Department of Pathology,School of Basic Medicine,Guizhou Medical University;

Email:

DOI: 10.19367/j.cnki.2096-8388.2020.08.016

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