大肠息肉和胃息肉的临床特点及病理特征回顾性分析

李薇薇; 王玉龙; 丁倩男; 姚刘旭; 李玉红

doi:10.16766/j.cnki.issn.1674-4152.002767

大肠息肉和胃息肉的临床特点及病理特征回顾性分析

doi: 10.16766/j.cnki.issn.1674-4152.002767

李薇薇¹,
王玉龙²,
丁倩男³,
姚刘旭^{2, 3},
李玉红^4, ,

1.
绍兴市人民医院消化内科，浙江绍兴 312000
2.
绍兴市人民医院麻醉科，浙江绍兴 312000
3.
绍兴市人民医院医学研究中心，浙江绍兴 312000
4.
浙江树人大学树兰国际医学院附属树兰(杭州)医院麻醉科，浙江杭州 310003

基金项目:

浙江省自然科学基金项目 LY21H150001

浙江省绍兴市人民医院青年科研基金项目重点项目 2019YA02

浙江省医药卫生科技计划项目 2020KY329

详细信息

通讯作者:
李玉红, E-mail: yuh_li@zju.edu.cn

中图分类号: R574.6 R573
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- 文章访问数: 271
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- PDF下载量: 8
- 被引次数: 0
出版历程
- 收稿日期: 2021-09-22
- 网络出版日期: 2023-02-07

A retrospective analysis of the clinical and pathological features of colorectal polyps and gastric polyps

1.
Department of Gastroenterology, Shaoxing People' s Hospital, Shaoxing, Zhejiang 312000, China

摘要

摘要: 目的分析绍兴市人民医院大肠息肉、胃息肉以及胃息肉合并大肠息肉患者的临床和病理特征。方法回顾性分析2017年6—11月在绍兴市人民医院行内镜检查发现的1 001例大肠息肉与1 219例胃息肉患者的临床、病理特征以及胃息肉合并大肠息肉患者的临床、病理特征。比较不同年龄段、不同性别大肠息肉和胃息肉的检出率、息肉的部位、数目、大小及病理类型等。结果大肠息肉检出率(14.35%)高于胃息肉(8.15%, χ²=200.568，P < 0.001)；2种息肉的检出率均随着年龄增加呈递增趋势(均P < 0.001)。胃息肉检出率女性高于男性(P < 0.001)，而大肠息肉男性高于女性(P < 0.001)。单发大肠息肉(91.71%)较单发胃息肉(73.17%)多见(χ²=232.500，P < 0.001)；≥1.0 cm的大肠息肉(18.58%)较胃息肉(5.50%)多见(χ²=93.200，P < 0.001)。在炎性息肉、腺瘤性息肉的检出率二者差异均有统计学意义(均P < 0.001)；胃息肉癌变率较大肠息肉低(P < 0.001)。胃息肉患者大肠息肉检出率显著高于普通人群(33.43% vs. 14.35%, P < 0.001)，以多部位、多发以及较少癌变为特征。结论胃息肉与大肠息肉，以及胃息肉合并大肠息肉与普通人群具有不同的临床和病理特征，为临床诊断和治疗提供参考。
- 大肠息肉 /
- 胃息肉 /
- 临床特点 /
- 病理特征 /
- 检出率
Abstract: Objective To analyse the clinical and pathological features of colorectal polyps, gastric polyps and gastric polyps combined with colorectal polyps in Shaoxing People ' s Hospital. Methods The clinical and pathological features of 1 001 cases of colorectal polyps and 1 219 cases of gastric polyps found by endoscopy in Shaoxing People ' s Hospital from June 2017 to November 2017, as well as the clinical and pathological features of gastric polyps combined with colorectal polyps were retrospectively analysed. The detection rate, location, the number and pathological types of colorectal and gastric polyps in different age groups and genders were compared. Results The detection rate for colorectal polyps (14.35%) was higher than that for gastric polyps (8.15%, χ²=200.568, P < 0.001). The detection rate for both polyps increased with age (P < 0.001). The detection rate for gastric polyps in women was higher than that in men, whereas the detection rate for colorectal polyps was higher in men than in women (P < 0.001). Single colorectal polyps (91.71%) were more common than single gastric polyps (73.17%, χ²=232.500, P < 0.001), and colorectal polyps ≥ 1.0 cm (18.58%) were more common than gastric polyps (5.50%, χ²=93.200, P < 0.001). The detection rates for inflammatory and adenomatous polyps were statistically significant (P < 0.001). The canceration rate of gastric polyps was lower than that of colorectal polyps (P < 0.001). The detection rate of colorectal polyps in patients with gastric polyps was higher than that of the general population (33.43% vs. 14.35%, P < 0.001), and characterised by multiple sites, multiple lesions and less canceration. Conclusion Gastric polyps, colorectal polyps and gastric polyps combined with colorectal polyps have different clinical and pathological features from the general population, which provide a reference for clinical diagnosis and treatment.
- Colorectal polyps /
- Gastric polyps /
- Clinical features /
- Pathological features /
- Detection rate

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图 1 胃息肉和大肠息肉的检出率随着年龄的变化趋势图

Figure 1. The trend chart of the detection rate of gastric polyps and colorectal polyps with age

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表 1 不同年龄段大肠息肉与胃息肉检出率比较

Table 1. Comparison of detection rates of colorectal polyps and gastric polyps in different age groups

年龄(岁)	肠镜检查		胃镜检查		χ²值	P值
年龄(岁)	例数	检出[例(%)]	例数	检出[例(%)]	χ²值	P值
< 20	27	1(3.70)	229	3(1.31)	0.900	0.343
20~39	943	83(8.80)	2 495	100(4.01)	31.205	< 0.001
40~59	3 727	536(14.38)	7 635	660(8.64)	87.525	< 0.001
≥60	2 280	381(16.71)	4 592	456(9.93)	65.479	< 0.001
合计	6 977	1 001(14.35)	14 951	1 219(8.15)	200.568	< 0.001

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表 2 各年龄段不同性别患者大肠息肉与胃息肉检出率的比较[例(%)]

Table 2. Comparison of detection rates of colorectal polyps and gastric polyps in patients of different sexes in different ages [cases (%)]

年龄(岁)	性别	肠镜检查		χ²值	P值	胃镜检查		χ²值	P值
年龄(岁)	性别	例数	检出[例(%)]	χ²值	P值	例数	检出[例(%)]	χ²值	P值
< 20	男性	21	1(4.76)	0.545	0.586	128	3(2.34)	1.549	0.121
	女性	6	0			101	0
20~39	男性	511	56(10.96)	2.543	0.011	1 264	45(3.56)	1.156	0.248
	女性	432	27(6.25)			1 231	55(4.47)
40~59	男性	1 746	303(17.35)	4.855	< 0.001	3 376	212(6.28)	6.546	< 0.001
	女性	1 981	233(11.77)			4 259	448(10.52)
≥60	男性	1 279	230(17.98)	1.841	0.066	2 364	163(6.90)	7.084	< 0.001
	女性	1 001	151(15.08)			2 228	293(13.15)

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表 3 年龄分层分析胃息肉人群和普通人群大肠息肉检出率比较

Table 3. Comparison of detection rate of colorectal polyps between gastric polyps population and general bpopulationy age stratification analysis

年龄(岁)	胃息肉人群		普通人群		χ²值	P值
年龄(岁)	例数	检出[例(%)]	例数	检出[例(%)]	χ²值	P值
20~39	27	9(33.33)	943	83(8.80)	18.400	< 0.001
40~59	215	67(31.16)	3 727	536(14.38)	44.180	< 0.001
≥60	120	4(37.50)	2 280	381(16.71)	33.749	< 0.001
合计	362	121(33.43)	6 977	1 001(14.35)	96.972	< 0.001

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表 4 性别分层分析胃息肉人群与普通人群大肠息肉检出率

Table 4. Detection rate of colorectal polyps in gastric polyp population and general population by sex stratification analysis

性别	胃息肉人群		普通人群		χ²值	P值
性别	例数	检出[例(%)]	例数	检出[例(%)]	χ²值	P值
男性	134	61(45.52)	3 560	590(16.57)	74.550	< 0.001
女性	228	60(26.32)	3 417	411(12.03)	38.870	< 0.001
χ²值		13.991		59.841
P值		< 0.001		< 0.001

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表 5 胃息肉人群与普通人群大肠息肉内镜检查下发生部位、数目和大小以及病理形态的比较

Table 5. Comparison of the location, number, size and pathological morphology of colorectal polyps between gastric polyp population and general population under endoscopy

息肉特点	胃息肉人群检出[例(%)]	普通人群检出[例(%)]	χ²值	P值	病理特点	胃息肉人群检出[例(%)]	普通人群检出[例(%)]	χ²值	P值
近端	26(21.49)	289(28.87)	34.720	< 0.001	炎性息肉	10(8.70)	114(12.21)	7.278	0.122
远端	80(66.12)	689(68.83)			增生性息肉	24(20.87)	195(20.88)
多部位	15(12.39)	23(2.30)^a			腺瘤性息肉	81(70.43)	583(62.42)
单发	75(61.98)	918(91.71)^a	9.682	< 0.001	癌变	0	41(4.39)^a
多发	46(38.12)	83(8.29)^a			其他	0	1(0.11)
< 1 cm	99(81.82)	815(81.42)	1.170	0.279
≥1 cm	22(18.18)	186(18.58)
注：本次统计中，普通人群行肠镜检查并检出大肠息肉共1 001例，胃息肉人群同时行肠镜检查并检出大肠息肉共121例；排除因各种原因未活检及已活检但未行病理检查者，普通人群有病理结果的大肠息肉共934例，胃息肉人群有病理结果的大肠息肉共115例。与胃息肉人群比较，^aP < 0.05, 。

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