Analysis Of Canceration Factors For Adenoma Of Large Intestine And Assessment Of Therapy By Endoscope

Objectives: To find the dangerous factors leading to the canceration of the adenomas of large intestine and the effect of the therapy of the adenomas by the colonoscopy through the retrospective analysis of material of colorectal adenomas confirmed by colonoscopy and pathology from 1992 to 2001 in our hospital to supply reference for the clinical.Methods: We gathered 630 patients (men 367 ,women 263)with adenomas of large intestine who received colonoscopy from 1992 to 2001. There were 849 adenomas with distinct pathologic diagnosis in total. We stasis the canceration number according to the patient' sexual distinction, the patient' age, multiple or single adenomas, the size of the adenomas, the histology type of adenomas, the position of adenomas respectively and analyzed the results with X2 test. Then we analyzed all these probable dangerous factors with logistic regression. We also gathered 256 patients who have received the second colonoscopy from one to two years after the first colonoscopy to know about the localrecurrence rate and the rate of the emergence of new adenomas.Results: (1) The distribution of the adenomas are mainly in rectum and sigmoid and the adenomas in rectum have the highest canceration rate (36.36%) significantly (p<0.05). (2) The age of the patients with adenomas of large intestine is mainly from 50 to 79 and there is a higher canceration rate for the patients older than 70 than the younger patients significantly (p<0.05). (3) In all kinds of the histology type, the tubular adenoma account for 45%, the villous adenoma account for 13%,the tubular-villous adenoma account for 25%. The canceration rate of the adenoma of large intestine from high to low in sequence is villous adenoma and tubular-villous adenoma, tubular adenoma. This is significant (p<0.05). (4) The big adenoma of large intestine is easier to cancerate than the small one. When the diameter of the adenoma is larger than 2cm, the canceration rate is 66.67%. (5) There is a multiple nature for the adenomas of large intestine . The patients with multiple adenoma account for 27.78% and there is a higher canceration rate for the patients with multiple adenoma than for the patients with single adenoma significantly (p<0.05). (6) The main dangerous factors for adenoma canceration in sequence are the size of adenoma, the histology type of adenoma and the patient' age .(7) Removing the adenomas of large intestine by fibro~colonoscope has a very low local recurrence rate during 1~2 years, but we should follow up the patient after the firstcolonoscopy. In order to find the new adenomas and the omitted adenomas.Conclusions: (1) The canceration of the adenomas of the large intestine easily occurs in patients older than 70 and patients with multiple adenomas. (2) The villous adenomas, the adenomas with diameter larger than 2cm and the rectum adenomas easily cancerate. (3) The main dangerous factors for adenoma canceration in sequence are the size of adenoma, the histology type of adenoma and the age of the patient .(4) Removing adenomas by fibro-colonoscope is effective ,but the follow-up is important.