【作者】 刘建军；

【导师】 何庆泗；

【作者基本信息】 山东大学 ， 普通外科， 2010， 硕士

【摘要】 目的：探讨直肠腺瘤的大小、细胞病理类型与直肠癌的相关性。方法：筛选2000年3月至2009年6月山东大学齐鲁医院普外科收治的89例单发的直肠腺瘤病例资料。按腺瘤最大横截面直径的大小、病理类型进行分类并分别对其差异进行统计学分析。结果：本组89例直肠腺瘤中：男性61例,女性28例,年龄26-84岁不等,中位发病年龄54岁。腺瘤直径小于2.0 cm的有57例,其中病理证实癌变的有2例(癌变率CR 3.5%)；直径在2.0～3.0 cm之间的有19例,癌变的有4例(CR21.0%)；直径大于3.0cm的有13例,癌变的有5例(CR 38.4%)。切除后病理结果分别是：管状腺瘤42例,其中癌变的有2例(CR 4.7%)；管状-绒毛状腺瘤23例,癌变的有6例(CR 26.1%)；绒毛状腺瘤24例,癌变的有9例(CR 37.5%)。用SPSS统计分析软件行卡方检验计算得知：最大横截面直径小于2.0 cm的直肠腺瘤与直径在2.0 cm-3.0 cm之间的直肠腺瘤癌变率比较,p<0.05；直径在2.0cm-3.0 cm之间的直肠腺瘤与直径大于3.0 cm的直肠腺瘤癌变率比较,p>0.05；直径小于2.0 cm的直肠腺瘤与直径大于3.0 cm的直肠腺瘤癌变率比较,p<0.05。病理类型为管状腺瘤的直肠腺瘤与管状-绒毛状腺瘤的直肠腺瘤比较,p<0.05；为管状-绒毛状腺瘤的直肠腺瘤与绒毛状腺瘤的直肠腺瘤比较,p>0.05；为管状腺瘤的直肠腺瘤与绒毛状腺瘤的直肠腺瘤比较,p<0.05。结论：本组筛选的89例患者资料中,根据SPSS统计学软件行x2检验的结果可知直径大于2.0cm的直肠腺瘤发生癌变的几率要大于直径小于2.Ocm的直肠腺瘤,且肿瘤直径越大,癌变几率就越大；病理类型是管状-绒毛状腺瘤和绒毛状腺瘤的直肠腺瘤发生癌变的几率要大于病理类型单纯为管状腺瘤的直肠腺瘤,且绒毛成分越多,癌变的几率也相应增大。更多还原

【Abstract】 Objective:To analyze the relativity between the size and the patholo of rectal polyps and rectal cancer.Methods:89 cases of rectal polyps treated in Shandong University Qilu Hospital from March 2000 to Jun 2009 were selectively collected. Categorize the max diameter and the patholo of the polyps and then make a statistic analysis about them.Results:There are 57 cases which of the diameter is below 2.0cm, in which 2 rectal cancer (canceration rate CR 3.5%),19 cases between 2.0-3.0cm, in which 4 rectal cancer (CR 21.0%), and 13 cases above 3.0cm, in which 5 rectal cancer (CR 38.4%).42 cases of tubular adenoma, in which 2 cases rectal cancer (CR 4.7%),23 cases of tubulo-villous adenoma, in which 6 cases rectal cancer (CR 26.1%), and 24 cases of villous adenoma, in which 9 rectal cancer (CR 37.5%). Use SPSS to analyze as the follows. The CR between which the diameter is below 2.0cm and 2.0-3.0cm is as P<0.05, the CR between which the diameter is 2.0-3.0cm and 3.0cm is as P>0.05, and the CR between which the diameter is 2.0cm and 3.0cm is as P<0.05. While the CR between the tubular adenoma and tubulo-villous adenoma is as P<0.05, the CR between the tubulo-villous adenoma and villous adenoma is as P>0.05,and the CR between tubular adenoma and villous adenoma is as P<0.05.Conclusions:According to the outcomes of the statistic analysis, the CR is bigger when the diameter of the rectal polyps larger than 2.0 cm, and the lager the polyps, the bigger the CR would be. The CR of the tubulo-villous adenoma is bigger than the tubular adenoma, while the more the villous lies in the polyps, the bigger the CR would be.更多还原