【摘要】 目的:分析结直肠锯齿状息肉患者的临床特征、内镜及病理表现,并比较中西方报道的差异,旨在为结直肠锯齿状息肉诊断和治疗提供参考。方法:分析总结天津医科大学总医院消化内镜中心近年来检出的结直肠锯齿状息肉患者的内镜、病理及临床特点,并与文献报道的西方国家的数据进行比较。结果:共28 981例患者进行了结肠镜检查,9 191例患者至少1枚结直肠息肉。其中锯齿状息肉检出率为0.53%(153/28 981),低于西方报道(1%～18%)。153例锯齿状病变中,增生性息肉(HP)、广基锯齿状腺瘤(SSA/P)、传统锯齿状腺瘤(TSA)所占比例分别为41.2%、7.2%和51.6%;而西方国家的研究显示,HP所占比例为70%～90%,SSA/P占10%～20%,TSA约占1%。锯齿状息肉在男性和年龄≥50岁的患者中检出率更高。153例锯齿状息肉中,大的锯齿状息肉(直径≥10 mm)和近端锯齿状息肉所占比例分别是13.7%(21/153)和46.4%(71/153)。此外,58.2%(89/153)的锯齿状腺瘤伴有异型增生。14例锯齿状息肉伴有同时性进展性结直肠肿瘤(sAN),其中大锯齿状息肉(LSPs)(OR值3.446,95%置信区间1.010-11.750,P<0.05)可能与伴发同时性进展性肿瘤有关。结论:结直肠锯齿状息肉检出率较低,3种亚型的比例与分布位置与西方的报道显著不同。大锯齿状息肉可能与伴发同时性进展性肿瘤的风险增加有关。更多还原

【Abstract】 Objective: This study was aimed to evaluate the features of colorectal serrated polyps in a Chinese population, and analyze the differences compared with those in western countries. The purpose of this study is to provide a reference for the diagnosis and treatment of colorectal serrated polyps. Methods: Data from all consecutive symptomatic patients were documented from a large colonoscopy database,and were compared with those in western countries through literature review. Results: A total of 9 191(31.7%) patients were detected with at least one polyp. The prevalence of serrated polyps was 0.53%(153/28 981), which was much lower than those in western countries(1%～18%).The proportions of hyperplastic polyp(HP), sessile serrated adenoma/polyp(SSA/P), and traditional serrated adenoma(TSA) of all serrated polyps were 41.2%, 7.2% and 51.6%, respectively, which showed a lower proportion of HP and SSA/P and a higher proportion of TSA,Western studies showed that the proportions of HP were 70%～90%, SSA/P were 10%～20%, and TSA were about 1%. Serrated polyps appeared more in males and elder patients. The proportion of large and proximal serrated polyps was 13.7%(21/153) and 46.4%(71/153),respectively. In addition, 58.2%(89/153) serrated adenomas were found with dysplasia. 14 patients with serrated polyps were found with synchronous advanced colorectal neoplasia,and large serrated polyps(LSPs)(odds ratio:3.446,95% confidence internal: 1.010-11.750,P <0.05) might have a association with synchronous advanced neoplasia(sAN). Conclusion: Colorectal serrated polyps have a lower detection rate in Chinese patients. The overall prevalence of colorectal serrated polyps and distribution pattern of three subtypes are significantly different in the Chinese population compared with those in western countries. LSPs might be associate with an increased risk of synchronous AN.更多还原