| Colorectal polyp is a common digestive disease, is a kind of vegetation on the colorectal mucosa.Different pathological types of polyps occurring in different risk of canceration, its treatment, prognosis, follow-up were also significant differences. It was reported that the probability of removal of polyps in the population relative to the population have not been removed or the general population suffering from colorectal cancer will reduce, so it is useful to explore the different pathological types of colorectal polyps in clinical and endoscopic performance in guiding the clinical diagnosis and treatment.Objective: To investigate the age, clinical features, location of polyp, size , pathology type and the relevant laws of canceration of colorectal polyp.Methods: The objects of study are people of outpatient and inpatients in the Grade III Class A hospital of changchun from August 2008 to August 2009 who acceptance of colonoscopy. In which the detection of colorectal polyps are 481 cases, all cases were obtained biopsy or polyp removal evacuation complete pathological examination. 261 cases of male, 220 cases of female, the youngest is 17 years old, the oldest is 86 years old. The use of Japanese OLYMPUS CF-260 E-colonoscopy. Patients from the outpatient physician according to conventional colonoscopy indications out the application and inform the inspection note and possible complications. The people who older than 60 years old and also have brain or lung or cardiovascular diseases are asked to signed a informed consent before the inspection. Taking the intestinal lavage fluid in the checking date until the excretion is water, that is the inspection standards. According to the results, recording the age distribution of colorectal polyps, clinical symptoms, colonic endoscopy and pathological features of type of colonoscopy, using statistical methods to explore the relevance of them. Clinical data will be established using Microsoft excel software database, statistical analysis using spss13.0 statistical software, statistical methods usingχ2 test and exact probability, there was statistically significant difference between the two groups if p <0.05. Results: Colorectal polyp is more common diseases in large intestine, in which men are slightly more than women, and the clinical manifestations are lack of specific. Mostly changes in bowel habits such as constipation and diarrhea, diarrhea are mostly accounted for 52.18% of 251 cases, constipation accounted for 47.82% of 230 cases, a small number occurring of blood in the stool, weight loss and anemia conditions.The mainly pathological type of polyps are inflammatory and tubular adenomas, tubular adenoma accounted for 37.21%, villous adenoma accounted for 6.03%, mixed-like adenoma accounted for 1.87%, juvenile polyps accounted for 2.08%, hyperplastic polyps accounted for 9.36 %, inflammatory polyps accounted for 43.45%. Polyps usually located in the rectum, sigmoid colon and descending colon. Most of them is rectum,accounted for 41.37%, the following is descending colon,accounted for 19.33%, and then is sigmoid colon, accounted for 18.30%, transverse colon accounted for 10.60%, ascending colon accounted for 11.64%, ileocecal accounted for 4.78%.Age and clinical symptoms, pathological classification and endoscopic features have a certain relationship. The people who is more older, the more likely to occur the blood in the stool and anemia, there is blood in the stool symptoms of old age group accounted for 12.61%, significantly higher than youth group and middle-aged group. The patients in youth group had no blood in the stool, weight loss and anemia symptoms. This group of 481 cases of polyps in patients with adenomatous polyposis type, accounting for 45.11%, followed by various types of tubular adenomas (37.21%), villous adenoma (6.03%), mixed-like adenoma (1.87%). Most of the pathological type in the elderly group is adenomatous polyps (63.87%), was significantly higher than the young group of the same pathological type (P <0. 01). Inflammatory polyps is important in the young group and the middle-aged group. Older group polyps≤0.5cm in diameter accounted for 38.66%, 0.6-1.0cm in diameter accounted for 24.37%,≥1.1cm in diameter accounted for 36.97%.Youth group, polyps≤0.5cm in diameter accounted for 65.85%, diameter of 0.6-1.0 cm accounted for 34.15%,≥1.1cm in diameter accounted for 18.50%.Middle-aged group, polyps≤0.5cm in diameter accounted for 49.22%, 0.6-1.0cm in diameter accounted for 36.76%,≥1.1cm in 5 diameter accounted for 14.02%. It is said that the more older, more greater possibility of polyps. Cancer rate in the elderly group was significantly higher than the youth group and middle-aged group (p <0.01), old age group accounted for 12.61% cancerous, youth group does not cancerous, middle-age group, cancer accounted for 0.93%. It is said that the more older, the polyps more likely to be cancerous.Weight loss and anemia in patients with multiple polyps are multiple and occur in multiple sites accounted for 28.57%, and other significant difference between the symptoms (p <0.01). Symptoms of anemia in patients with polyps≥1.1cm in diameter accounted for6.74%, byχ2 test and other symptoms are significantly different (p <0.01). Blood in the stool occurs in patients with cancer accounted for 15.38%, and anemia occurred in patients with cancer accounted for 28.57%, significantly higher than other clinical symptoms in patients with cancer rate (p <0.01). Several pathological type of polyp adenomatous polyp larger than normal diameter of the non-adenomatous polyps.≤1.0cm in diameter multi-non-neoplastic polyps (including inflammatory, hyperplastic, juvenile polyps). Tubular adenoma and villous adenoma diameter, larger and prone to cancer. Adenomatous polyps, the greater the volume the greater the likelihood of cancer. The results showed that this group of inflammatory polyps, juvenile polyps and hyperplastic polyps without cancer from happening.Polyps in patients with multiple polyps in the distribution of parts of many of the sigmoid colon and descending colon, and the cancer rate is higher than single patients. Occur in multiple cancerous polyps accounted for 15.38%, significantly higher than the rate of single polyps, the test statistically significant differences (p <0.01).≥1.1cm in diameter of the cancer incidence rate of 17.98%, while not cancerous polyps≤0.5cm in diameter, 0.6-1.0cm in diameter in the cancer incidence rate was 1.24%, indicating that the larger polyp, the higher cancer rate.Conclusions: The clinical manifestations of colorectal polyps is not specific; the more older,the more possibility to cccur blood in the stool and anemia, pathological type of polyps are mostly adenomatous polyps in older group, the more older,the more possibility to cccur canceration. Adenomatous polyps, mainly in the non-adenomatous polyps, and more prone to cccur canceration, the greater the polyps is,the more possibility to cccur canceration. Indicating that the clinical symptoms, endoscopic characteristics and pathological classification of colorectal polyps has a close relationship. Colonoscopy in the crowd to expand the scope of subjects, and remove the polyps as soon as possible, can reduce the incidence of colorectal cancer. |
PDF Full Text Request