Analysis Of Clinical, Pathological And The Canceration Features In 1347 Cases Of Colorectal Polyps

Objective:Through the analysis of the incidence of patients with colorectal polyps, Clinical manifestations, endoscopic features, pathological types and the cancerous rule, in order to deepen awareness, early diagnosis, timely treatment.Methods:Choosing 3798 hospitalized patients who received colonoscopy between January 2012 and June 2014 in our hospital,1347 patients with colorectal polyps and totaled 4005 polyps were detected, including 1247 cases with endoscopic biopsy or complete removal for pathology. Age, gender, clinical manifestations, endoscopic characteristics, pathological types and canceration were recorded detailedly during the procedure of colonoscopy so as to make classification and evaluation standard and establish the database. Pearson ?2 test, Fisher's exact probability method, binary unconditioned Logistic regression analysis and Kruskal Wallis rank-sum were used to make a statistical analysis. Multiple comparison between groups was applied when the differences had statistical sense.Results:The total detection rate for the colorectal polyps is 35.47%, of which in young, middle-aged and elderly group is 15.07%,33.4%,46.14% respectively, and the prevalence is higher in men than in women (41.61%>29.28%), with statistical sign-ifyance (P<0.01). Logistic regression analysis shows that age and sex are independent risk factors in morbidity of colorectal polyps. The main clinical manifestations consist of abdominal pain (37.79%), diarrhea (12.69%), constipation (8.69%), hematochezia (8.54%), abdominal distension (7.72%), emaciation (4.31%), alternate episodes of diarrhea and constipation (2.75%), and patients without digestive symptom account for 17.52%. Middle-aged or elderly patients are more likely to asymptomatic and hematochezia than young, and the incidence of diarrhea is higher in the youth group, differences between the two groups are also significant (P<0.017). Mainly polyps happens in the distal colon,32.03% in rectum,27.49% in sigmoid colon and 15.13% in transverse colon, and there are no differences between age and pathology groups (P>0.05). Multiple colorectal polyps play a very large part (63.25%), but single polyps are more likely to be found in the young patients (50.96%). Most of polyps diameter less than or equal to 0.5cm (81.35%). Morphological characteristics mainly for sessile polyp (?, ? type,58.60%) and surface-smooth polyp (86.82%), there are significant differences between the three groups (P<0.05). Tubular adenoma (40.13%), hyperplastic polyp (33.22%) and inflammatory polyp (18.03%) are the common pathological types in this research. Adenomas can be easier found in the old group (56.08%), comparing to the young and middle-aged groups, which non-adenomatous polyps consisting of the most part (P<0.017), without sexual difference (P>0.05). Adenomas are more common seen in multiple (54.41%), larger diameter (>0.5cm, 73.35%), ? or ? types (arch or pedunculated polyps,62.87%) and lobulated (88.43%) polyps than non-adenomatous polyps, with statistical significance (P<0.01). Different degree of dysplasia can be found in every types of polyps, most of which are mild and moderate dysplasia. Adenomas have a 88.11% in the dysplasia polyps, and severe dysplasia or canceration polyps were all found in adenomas. The canceration rate of adenomas is 2.67%, meanwhile, villous adenoma and villioustublar adenoma has the highest canceration rate. The canceration polyps mainly including multiple polyps (1.7%), surface lobulated polyps(10.32%), diameter >2.0cm (11.58%), with statistical signifycance (P<0.05). The canceration rate did not correlate with age, gender, geographical position and type (P>0.05).Conclusion:1. Age and sex are independent risk factors in colorectal polyps.2. 0.5 centimeter or less in diameter, smooth-faced and non-pedicle-type are the main forms in colorectal polyps, whose location mainly are rectum and sigmoid colon, what's more, age and pathological pattern have no matter with the distribution.3. Adenoma has the characteristics with multiples, bigger diameter, irregular shapes and advanced age. Villous adenoma and villioustublar adenoma with multiple, surface lobulated, diameter>2.0cm or severe dysplasia are inclined to canceration.4. People with gastrointestinal symptoms and middle-elderly population both need colonoscopy, and polyps found under the colonoscopy should complete excision and pathological inspection, so as to guide the next of follow-up visit.