Clinical, endoscopic, histopathological characteristics of patients with colorectal polyps - Endoscopy Gastroenterology Center, Hue University of Medicine and Pharmacy Hospital

Ha Nguyen Van Thu, Ngoc Nguyen Phan Hong
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Abstract

Background: Colorectal polyps are a relatively common diseases in the group of lower gastrointestinal tract diseases. The prevalence of colorectal polyps ranges from 20 to 50%. Polyps are formed due to excessive hyperplasia of the mucosa and the malignancy rate of colorectal polyps is higher than other sites. Objectives: (1) To describe some clinical and endoscopic features of colorectal polyps; (2) To evaluate the histopathological characteristics and the relationship between histopathology and some clinical and endoscopic features of colorectal polyps. Subjects: The patients aged 16 years old and older who were diagnosed with colon polyps at the Center for Gastroenterology - Endoscopy at Hue University of Medicine and Pharmacy Hospital from April 1st, 2020 to March 30th, 2021. Methods: Cross-sectional, retrospective description. Results: Study on 67 patients who were dianosiged as having colorectal polyps through endoscopy, in which, 48 patients underwent polypectomy and histopathology. The mean age is 55.8 ± 15.7 years old, the most common age group is ≥ 45 years old, male/female is 2/1. The time from symptoms onset to disease detection is usually 6 months to less than 1 year (37.4%). The common clinical symptoms: abdominal pain (83.6%), diarrhea (29.9 %), constipation (28.4%), dysentery syndrome (13.4%), bloody stools (31.3%). The position of polyps: anus (1.5%), rectum (47.8%), sigmoid colon (40.3%), descending colon (31.3%), transverse colon (22.4%), ascending colon (28.4) %), cecum (13.4%). The proportion of patients having ≥ 2 polyps (59.7%), 1 polyp (40.3%). Polyp sizes: 5 - < 10 mm (50.7%), < 5 mm (37.4%), ≥ 10 mm (11.9%). The percentage of sessile polyps is higher than that of pedunculated polyps at each locations. Histopathological types: adenomatous polyps (60.4%), hyperplastic polyps (20.8%), malignant polyps (4.2%). Polyps with dysplasia (64.6%), mild – grade dysplasia (56.3%), severe-grade dysplasia (8.3%). The differences were statistically significant between the grade of dysplasia and the polyp size groups, between the histopathology and the grade of dysplasia (p < 0.05). Conclusions: Colorectal polyps are more common in patients ≥ 45 years old, male are much more of having than female. Abdominal pain, bloody stools are common symptoms. Common polyp phenotypes are sessile polyps, ≥ 2 polyps, 5 - < 10 mm in size, mainly in the rectum. Adenomatous polyps are the most common histopathological type, with the high rate of dysplasia. Key words: clinical, endoscopy, histopathology, colorectal polyps.
结直肠息肉患者的临床、内镜、组织病理学特征-顺化医科大学附属医院胃病内镜中心
背景:结直肠息肉是下消化道疾病组中较为常见的一种疾病。结直肠息肉的发病率从20%到50%不等。息肉是由于粘膜过度增生而形成的,结直肠息肉的恶性发生率高于其他部位。目的:(1)探讨结直肠息肉的临床及内镜特征;(2)评价结直肠息肉的组织病理学特点,以及组织病理学与部分临床及内镜特征的关系。研究对象:于2020年4月1日至2021年3月30日在顺化医科大学附属医院胃肠病学-内窥镜中心诊断为结肠息肉的16岁及以上患者。方法:横断面、回顾性描述。结果:对67例经内镜诊断为结直肠息肉的患者进行了研究,其中48例进行了息肉切除术和组织病理学检查。平均年龄55.8±15.7岁,最常见年龄组≥45岁,男女比例为2/1。从出现症状到发现疾病的时间通常为6个月至不到1年(37.4%)。常见临床症状:腹痛(83.6%)、腹泻(29.9%)、便秘(28.4%)、痢疾综合征(13.4%)、便血(31.3%)。息肉部位:肛门(1.5%)、直肠(47.8%)、乙状结肠(40.3%)、降结肠(31.3%)、横结肠(22.4%)、升结肠(28.4%)、盲肠(13.4%)。息肉≥2个(59.7%)、1个(40.3%)的患者比例。息肉大小:5 - < 10mm (50.7%), < 5mm(37.4%),≥10mm(11.9%)。各部位无梗息肉的百分比高于有梗息肉的百分比。组织病理类型:腺瘤性息肉(60.4%)、增生性息肉(20.8%)、恶性息肉(4.2%)。息肉伴发育不良(64.6%),轻度发育不良(56.3%),重度发育不良(8.3%)。异常增生分级与息肉大小组、组织病理学与异常增生分级比较,差异均有统计学意义(p < 0.05)。结论:结直肠息肉多见于年龄≥45岁的患者,男性多于女性。腹痛、便血是常见症状。常见的息肉表型为无根性息肉,≥2个,大小5 - < 10mm,主要发生在直肠。腺瘤性息肉是最常见的组织病理学类型,异常增生率高。关键词:临床,内镜,组织病理学,结肠息肉。
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