The Study Of Clinical Character And Histopathological Lesion Associated With The Correlation Factors Of Malignant Transformation In Colorectal Polyps

Objective:To probe the relation with clinical and pathological characteristics and malignant transformation in colorectal polyps.Methods.A total of 1482 subjects had colorectal polyps with complete colonoscopy.The age onset,location,size,appearance,numbers,histopathological lesion,degree of atypical hyperplasia and malignant transformation of colorectal polyps were evaluated,identify the relation ship with clinical and pathological characteristics and malignant transformation in colorectal polyps.Results:Colorectal polyps were diagnosed in 15.4%of patients,they had male susceptibility.Among main clinical manifestations of patients with colorectal polyps,patients with juvenile polyps had the highest rate of hemafecia. Colorectal polyps were found in different age classes and more frequent(74.0%) in individuals over 40 years.Different histological colorectal polyps were frequently observed on rectum and sigmoid colon.The peak of age of onset in inflammatory polyps were between 31 and 40 years,inflammatory polyps had some characteristics such as smaller average size,more sessile,lese lobular. Hyperplastic polyps had the same appearance with that of inflammatory polyps except the comparatively large span of age of onset(31～60 years).Adenomatous polyps had different characteristics of larger average size and more lobular,their detection rate had the tendency increased with the age.Juvenile polyps had smaller age of onset,larger average size,more lobular and more pedunculated, most of them are solitary.High-grade atypical hyperplasia was only found in adenomatous polyps,and atypical hyperplasia was not found in juvenile polyps.Seventy two polyps were found to be malignant(4.9%).The character of malignant transformation in colorectal polyps was classified as follows:they were frequently observed on rectum and sigmoid colon;appearing frequently in individuals over 40 years;often greater than 2.0 cm in diameter(p＜0.05); colorectal polyps with lati-basement,sublobe and numbers have the higher probability of malignant transformation.Adenomatous polyps were found to be malignant(8.6%),and villous adenoma was the facter of high risk,its malignant rate in 38.5%.The malignant rate of polyps were remarkably increased with the degree of atypical hyperplasia(p＜0.01),and the malignant rate of high-grade atypical hyperplasia polyps reached to 84.0%.Conclusions:Different histological colorectal polyps have some different clinical characteristics,it can be reference to distinguish different histological polyps.Malignant transformation of colorectal polyps is associated with age of onset,location,size,appearance,numbers,histopathological lesion and degree of atypical hyperplasia.They were frequently observed on rectum and sigmoid colon;appearing frequently in individuals over 40 years;colorectal polyps with lati-basement,sublobe,numbers and than 2.0 cm in diameter have the higher probability of malignant transformation;villous adenoma was the facter of high risk;the malignant rate of polyps were remarkably increased with the degree of atypical hyperplasia.