Clinical Characteristics Analysis Of Colorectal Adenomatous Polyps

Purpose:To investigate the most common clinical features of colorectal adenomatous polyps as warning manifestations and their different characteristics of different positions and to explore if there was a posibility of different potential malignant transformation between different locations.Methods:The clinical and endoscopic data of 312 cases with colorectal adenomatous polyps diagnosed by coloscopy or in operation from January,2006 to September,2009 were analyzed retrospectively. Colorectal adenomatous polyps which arise proximal (right) or distal (left) to the splenic flexure were divided into three groups, that is left colon group, right colon group and whole colon group and comparative analysis for the clinical and endoscopic data among the three groups and multiple comparison were conducted.Results:1. The susceptible age periods for colorectal adenomatous polyps were 41 to 70 years. The main distribution site of polyps was left colon, accounting for 54.2%. The commonest clinical symptoms were Abdominal Pain(43.6%), diarrhea(36.2%) and bloody stool(27.6%). 66% of the patients were combined with others diseases.55.1% patients were with abnormal abdominal ultrasound, among which 23.5% patients had gallbladder disease.The diameter of the adenomatous polyps under endoscopy were mostly concentrated in 6mm-20mm (77%).46.8% of the polyps were more than 1cm.49% were sessile polyps and 72.4% were with surface congestion and (or) erosion.45.5% were with intestinal inflammation.8.7% cases were with high atypical hyperplasia and 223 cases (71.5%) were high risk polyps。2. The significant index among the three groups were:gender,body weigh,the times of polypectomy,blood calcium,the abnormity of abdominal ultrasound,the size of polyps,polyps pedicle,congestion and (or) erosion of polyps。3. The significant index between the left colon group and the right colon group were:the times of polypectomy,diarrhea,the number of diarrhea,the abnormity of abdominal ultrasound,intestinal inflammation。4. The significant index between the right colon group and the whole colon group were:gender,body weight,the abnormity of abdominal ultrasound,the size of polyps,congestion and (or) erosion of polyps。5. The significant index between the left colon group and the whole colon group were:body weight,gender,operation history,the number of polyps,polyps pedicle,congestion and (or) erosion of polyps。6. The rate of high risk group differed between the three groups and any two groups. Conclusions:1,Those aged, male patients of colorectal adenomatous polyps with the symptoms of abdominal pain, diarrhea, bloody stool, abnormal dyslipidemia and with gallbladder disease in abdominal ultrasound were of high risks and should have total colonoscopy.2,More patients with adenomatous polyps of left colon had diarrhea than that of right colon.3,Possiblely, after the polypectomy, the recurrence rate of the adenomatous polyps in the right colon was higher than that of in the left colon.4. The malignant potential of those with adenomatous polyps in the whole colon significantly increased than the other two groups, and the malignant potential of left colon is higher than the right colon.