摘要
目的:分析结直肠侧向发育型肿瘤(LST)癌变的危险因素.方法:回顾2021年1月至2022年12月我院收治的79例LST患者资料,总结LST患者临床病理特征,并根据术后病理结果分为癌变组(14例)和非癌变组(65例),分析癌变的危险因素.结果:LST患者病灶长径＜40 mm(92.4％)、病灶多发(93.67％)、巴黎分型0～Ⅰ s(53.16％)、病变部位在右半结肠(53.16％)、非抬举征阴性(91.14％)、基底或切缘阴性(88.61％)者居多.癌变组与非癌变组在年龄、性别、病灶数目、巴黎分型、病变部位、术前活检、非抬举征、基底或切缘浸润、肠息肉病史、糖尿病病史、高血压病史、退镜时间、吸烟史、饮酒史、手术方式方面比较差异均无统计学意义,P＞0.05;但在病灶长径、内镜分型、结直肠癌病史方面差异有统计学意义,P＜0.05.Logistic回归分析显示,病灶长径＞40 mm、内镜分型为结节混合型LST(LST-GM)和假凹陷型LST(LST-NG-PD)是LST患者癌变的危险因素,P＜0.05.结论:LST具有独特的临床病理特征,病灶长径＞40 mm、内镜分型为LST-GM和LST-NG-PD的LST患者易发生癌变.
Abstract
Objective To analyze the cancerization risk factors of colorectal laterally spreading tumor(LST).Methods The data of total 79 patients with LST admitted to our hospital from January 2021 to December 2022 were retrospectively analyzed.The patients'clinicopathological features were summarized,and they were divided into the cancer group(14 cases)and non-cancer group(65 cases)according to the postoperative pathological results,and the cancerization risk factors were analyzed.Results Most pa-tients with LST had lesions with long diameter ≤40 mm(92.4％),multiple lesions(93.67％),Paris clas-sification 0～Ⅰ s(53.16％),lesions in the right colon(53.16％),negative non-lifting sign(91.14％),and negative base or incisal margin(88.61％).There was no significant difference between the cancer group and the non-cancer group in age,gender,number of lesions,Paris classification,lesion location,preoperative biopsy,non-lifting sign,basal or incisal invasion,history of intestinal polyp,diabetes,hypertension,endo-scopic withdrawal time,smoking and drinking history,and surgical method(P＞0.05).However,there were statistically significant differences in long diameter of lesions,endoscopic type and history of colorec-tal cancer(P＜0.05).Logistic regression analysis showed that lesions with long diameter＞40 mm and endoscopic classification of LST-GM and LST-NG-PD were the risk factors of cancerization in patients with LST(P＜0.05).Conclusion LST has unique clinicopathological features.LST patients with focal di-ameter＞40 mm and endoscopic classification of LST-GM and LST-NG-PD are prone to malignant degen-eration.
基金项目
河南省科技公关计划联合共建课题(2018020981)
国家科技期刊平台
NSTL
维普
万方数据