【摘要】 目的:研究直肠和结肠来源的侧向发育型肿瘤(laterally spreading tumor,LST)的临床病理特征之间的差异。方法:回顾性分析中南大学湘雅二医院2012年1月至2017年1月确诊的198例LST患者(直肠116例,结肠82例)的临床病理资料。结果:198例患者按内镜分型来看,结节混合型127例(64.1%),颗粒均一型13例(6.6%),扁平隆起型41例(20.7%),假凹陷型17例(8.6%);结节混合型更常见于直肠(71.7%),扁平隆起型更常见于结肠(78.0%),两者差异有统计学意义(P<0.01);直肠LST直径为(52.03±35.62)mm,结肠LST直径为(25.37±11.56)mm,两者比较差异有统计学意义(P<0.01);直肠LST与结肠LST相比较,高级别上皮内瘤变的比例更高(分别为31.0%和18.3%),低级别上皮内瘤变的比例则较低(分别为61.2%和75.6%)(均P<0.05);直肠LST与结肠LST相比较,结节混合型和颗粒均一型的直径更大,结节混合型拥有更高的恶性潜能(高级别瘤变+浸润癌的百分率分别为41.8%和22.2%)(均P<0.05);结肠LST多采用内镜下黏膜切除术治疗,直肠LST多采用内镜黏膜下剥离术治疗。结论:直肠LST与结肠LST表现出某些不同的临床病理特征,结节混合型LST更常见于直肠,扁平隆起型LST更常见于结肠,直肠结节混合型LST可能具有更高的恶性潜能。更多还原

【Abstract】 Objective:To investigate the clinicopathological differences in laterally spreading tumor(LST) from the rectum and colon.Methods:Clinicopathological records of 198 patients with LST(116 cases in rectum,82 cases in colon) from the Second Xiangya Hospital of Central South University between January 2012 and January 2017 were evaluated.Results:A total of 198 colorectal LST were included.According to the endoscopic classification,nodular mixed type(LST-GM),homogeneous type(LST-GH),flat elevated type(LST-FE)and pseudodepressed type(LST-PD) were 127(64.1%),13(6.6%),41(20.7%) and 17(8.6%),respectively.LST-GM was predominant in the rectum(71.7%),while LST-FE was predominant in the colon(78.0%),with significant difference(P<0.01).The mean size of LST was(52.03±35.62) mm or(25.37±11.56) mm in the rectum or the colon,with significant difference between them(P<0.01).High grade intraepithelial neoplasia frequency was higher in the rectum than that in the colon(31.0% vs 18.3%),while the low grade intraepithelial neoplasia frequency was lower in the rectum than that in the colon(61.2% vs 75.6%)(both P<0.05).The mean size of LSTGM and LST-GH diameter were larger in the rectum than that in the colon,and the malignant potential of LST-GM was higher in the rectum than that in the colon.The percentage of high grade intraepithelial neoplasia + invasive carcinoma was 41.8% and 22.2%,respectively(both P<0.05).LST in colon was mostly treated with endoscopic mucosal resection,while LST in rectum was treated by endoscopic submucosal dissection predominantly.Conclusion:LSTs from the rectum and colon show different clinicopathological characteristics to some extent.LST-GM is predominant in the rectum,while LST-FE is predominant in the colon.The malignant potential of LST-GM is higher in the rectum than that in the colon.更多还原