Clinical Characteristics And Pathological Analysis Of Children With Colon Polyps

Objective The purpose of this study is to explore the gender,age,clinical characteristics,Endoscopic morphological and pathological features of children with colonic polyps,to improve the understanding of clinical characteristics and pathological types of colonic polyps,and to provide reference for the diagnosis and treatment.Methods The clinical data of children with colonic polyps in our hospital from January 2003 to August 2019 diagnosed by electronic digestive endoscopy were selected to analyze the characteristics of gender,age,clinical manifestations,morphology and pathological types of colonic polyps.Results1.Age and gender features: there were 246 cases in this study,of which72.4%(178/246)were boys and 27.6%(68/246)were girls.The youngest was 8months,the oldest was 13 years and 5 months,and the average age of patients was 4.68 ± 1.95 years.The group of less than 3 years old accounted for 21.1%(52/246),the group of 3-6 years old accounted for 60.6%(149/246),and the group of 6 years old or older accounted for 18.3%(45/246).The age of onset was 3 to 6 years old.The composition ratio of male and female in different age groups was compared,and difference was not statistically significant(P>0.05).2.Clinical features: The frequency of clinical manifestations from high to low was: hematochezia,94.7%(233/246),abdominal pain,29.3%(72/246),mucous feces,19.5%(48/246),anemia,18.7%(46/246),polyps emerge from the anus,14.2%(35/246),constipation,7.7%(19/246),related allergic diseases,7.7%(19/246)(including food drug allergy and asthma,urticaria).The incidences of various clinical manifestations in different gender groups were compared,and the differences were not statistically significant(P>0.05).The incidences of abdominal pain in different age groups were compared,and the differences were statistically significant(P<0.05).Further pairwise comparison between the two groups showed that the incidences of abdominal pain in the group of 3-6 years and the group of 6 years old or older were higher than that in the group of less than 3 years old,and the differences were statistically significant(P<0.017).However,the incidences of other clinical manifestations were not statistically significant in different age groups(P>0.05).3.Location and morphology: There are 328 polyps,including rectal polyps accounting for 61.6%(202/328),sigmoid polyps accounting for 24.4%(80/328),descending colon polyps accounting for 8.5%(28/328),transverse colon polyps accounting for 4.3%(14/328),and ascending colon polyps accounting for 1.2%(4/328).Sessile polyps accounted for 23.8%(78/328),semipedunculated polyps accounted for 34.1%(112/328),and pedunculated polyps accounted for 42.1%(138/328).4.The number features of polyps: Solitary polyp accounted for 82.5%(203/246)and multiple polyps accounted for 17.5%(43/246).Comparing the composition ratio of solitary polyp and multiple polyps in the different gender groups and different disease course groups,differences were not statistically significant(P>0.05).Comparing the composition ratio of solitary polyp and multiple polyps in the different age groups,difference was statistically significant(P<0.05).By further multiple comparisons,compared with the group of less than 3 years old,the group of 3-6 years and the group of 6 years old or older was higher composition ratio of multiple polyps,and difference was statistically significant(P<0.017).While comparing the composition ratio of solitary polyp and multiple polyps between the group of 3-6 years and the group of 6 years old or older,difference was no statistically significant(P>0.017).There was no statistically significant difference in the incidence of constipation and the proportion of allergic diseases between the single polyp group and the multiple polyp group(P>0.05).5.The size features of polyps: Small polyps accounted for 59.3%(146/246),large polyps accounted for 41.7%(100/246).Comparing the composition ratio of small polyps and large polyps in the different gender groups and different age groups,differences were not statistically significant(P>0.05).Comparing the composition ratio of small polyps and large polyps in different disease course groups,difference was statistically significant(P<0.05).There was statistically significant difference in the incidence of constipation between the large polyp group and the small polyp group(P<0.05),while there was no statistically significant difference in the incidence of allergy related diseases(P>0.05).6.The pathological characteristics of polyps: juvenile polyps accounted for85.0%(209/246),inflammatory polyps accounted for 7.3%(18/246),hyperplastic polyps accounted for 5.7%(14/246),and adenomatous polyps accounted for 2.0%(5/246).There is no significant difference in the proportion of pathological types among different gender,different age groups,different polyp numbers and different polyp sizes.One cases of juvenile polyps shows moderate atypical hyperplasia.Adenomatous polyps are found 5 cases.Conclusion1.The incidence of boys with colonic polyps is higher than that of girls,and the peak of the disease is at the age of 3 to 6.2.Hematochezia is the most important clinical manifestation of intestinal polyps,which can be accompanied by abdominal pain,mucous feces,polyps emerge from the anus,constipation.3.Rectum and sigmoid colon are the most frequent sites of intestinal polyps,and a few polyps are distributed in other parts of colon.4.Most polyps occur in older patients(≥3 years old).5.Patients with long disease course(≥6 months)and constipation tend to have large polyps.6.The main pathological type of colonic polyp in children is juvenile polyps.A few are inflammatory polyps,hyperplastic polyps and adenomatous polyps.