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山东大学学报(医学版) ›› 2014, Vol. 52 ›› Issue (3): 92-95.doi: 10.6040/j.issn.1671-7554.0.2013.578

• 临床医学 • 上一篇    下一篇

大肠腺瘤性息肉经内镜切除后高复发人群的筛查

李光春1,司志雯1,吴洪磊1,周成军2,朱孔锡1,刘斌1,郭建强1   

  1. 山东大学第二医院 1.消化内科; 2.病理科, 山东 济南 250033
  • 收稿日期:2013-09-23 出版日期:2014-03-10 发布日期:2014-03-10
  • 通讯作者: 郭建强。 E-mail:Jianqiangg@sdu.edu.cn

Screening of high-risk population after endoscopic polypectomy of colorectal adenomatous polyps

LI Guangchun1, SI Zhiwen1, WU Honglei1, ZHOU Chengjun2, ZHU Kongxi1, LIU Bin1, GUO Jianqiang1   

  1. 1. Department of Gastroenterology; 2. Department of Pathology, Second Hospital of
    Shandong University, Jinan 250033, Shandong, China
  • Received:2013-09-23 Online:2014-03-10 Published:2014-03-10

摘要:

目的  探讨大肠腺瘤性息肉内镜治疗后复发的相关因素,从而筛查出易复发的高危人群,为腺瘤性息肉患者的随访提供依据。方法  回顾性分析2000年1月至2013年3月行大肠腺瘤性息肉切除患者在随访期间的复发情况。行单因素χ2检验及多因素Logistic回归分析进行统计推断,分析各种危险因素与腺瘤性息肉复发的相关性。结果  随访期间共249例患者复发腺瘤,复发比例为26.83%。单因素分析显示,腺瘤复发与年龄,腺瘤数目、直径、部位、类型,瘤变程度,基底部及治疗方式有关,而与性别无明显相关性。多因素Logistic回归分析显示,年龄,腺瘤数目、直径、类型,瘤变程度,基底部是腺瘤复发的独立危险因素,而腺瘤部位及治疗方式并非独立危险因素。结论  符合年龄>60岁、个数≥3个、直径>10mm、绒毛状结构、高级别上皮内瘤变、无蒂等特点的患者属于高危人群,符合的因素越多,腺瘤复发率可能越高,需要密切随访。

关键词: 腺瘤性息肉, 高危人群, 复发因素, 随访

Abstract:

Objective  To investigate the correlative factors for the recurrence of adenomatous polyps after endoscopic treatment so as to screen out high risk people and to provide information for proper surveillance. Methods  The data of the adenoma recurrence among patients undergone endoscopic polypectomy from January 2000 to March 2013 were retrospectively reviewed. Univariate χ2 test and multivariate logistic regression analysis were performed to analyze the association between risk factors and adenoma recurrence. Results  A total of 249 cases (26.83%) developed new adenomas during the follow-up. Univariate analysis indicated that adenoma recurrence was associated with age, number of adenomas, adenoma diameter, location, pathological type, grade of dysplasia, basilar part and treatment method, but not with gender. Logistic regression analysis revealed that age, number of adenomas, adenoma diameter, pathological type, grade of dysplasia, and basilar part were independent risk factors of adenoma recurrence whereas adenoma location and treatment method were not. Conclusion  Patients aged 60 years, with adenoma number ≥3, diameter > 10mm, villous, high grade of dysplasia and sessile adenoma, have high risk of adenoma recurrence. Adenomas tend to recur in patients with more risk factors; therefore, intensive surveillance is recommended.

Key words: Recurrence factor, High-risk group, Surveillance,  Adenomatous polyp

中图分类号: 

  • R574.6
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