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结直肠锯齿状病变242例内镜和病理特征分析
Endoscopic and pathological features of colorectal serrated lesions: a retrospective analysis of 242 cases

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DOI:
作者:
任大宾，徐萍，赖跃兴，孙玮玮，徐凯，王静，于海滨
REN Da-bin
作者单位:
上海市松江区中心医院
Department of Gastroenterology，Songjiang Central Hospital,Shanghai(201600)
关键词:
锯齿状病变；病理学，临床；结肠镜检查
Serrated lesion; Pathology; Clinical; Colonoscopy
摘要:
目的 探讨结直肠锯齿状病变内镜下形态和病理组织学特征。方法 回顾分析我院消化内镜中心2012年1月至2014年12月检出的242枚锯齿状病变的内镜和病理资料。结果 242枚锯齿状病变中145枚为隆起型，97枚为表面型，其中右半结肠检出74枚，左半结肠检出168枚；多数锯齿状病变直径小于10mm。组织病理学管状、管状绒毛状和绒毛状锯齿状病变分别为91、124和27枚；不典型增生程度轻度144枚，中度16枚。管状腺体低级别上皮内瘤变的检出率低于管状绒毛状腺体及绒毛状腺体（P<0.01）。Pit分型ⅢL型和Ⅳ型低级别上皮内瘤变检出率要明显高于Ⅱ型（P<0.01）。结论 结肠锯齿状病变在结肠息肉中占一定检出率，且具有上皮内瘤变倾向，需要引起内镜医师重视。
Objective To explore the endoscopic and pathological features of colorectal serrated lesion. Methods We performed a retrospective analysis of 242 cases of colorectal serrated lesion, whose endoscopic and pathological data were collected in the Digestive Endoscopy Center of our Hospital from January 2012 to December 2014. Results 242 subjects were enrolled, including 145 protruded and 97 superficial cases, with 74 lesions located in the right colon and 168 lesions located in the left colon. The majority of serrated lesions less than 10mm in diameter.Colorectal serrated lesions represented three histopathological subtypes, with 91 cases of tubular glands, 124 cases of tubulovillous glands and 27 cases of villous glands. Mild dysplasia was found in 144 subjects and moderate dysplasia in 16 cases. Low grade intraepithelial neoplasia was less frequently detected in tubular glands than in tubulovillous or villous glands. （P<0.01）. The rate of low grade intraepithelial neoplasia was obviously higher in Pit Pattern ⅢL and Ⅳ than that in Pit Pattern Ⅱ(P<0.01). Conclusion Colon serrated lesions in the colon polyps in a certain detection rate, and has a tendency to intraepithelial neoplasia, need to be cautious by endoscopic physicians.

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