大肠腺瘤癌变大肠镜活检病理40例观察(1)
【摘要】 目的：探讨并研究大肠腺瘤发生癌变的临床病理特点以及免疫组化实验情况。方法：选取2013年1月-2014年12月在本院行纤维肠镜检查的13 167例患者作为研究对象，共检出大肠腺瘤3144例，82例行CEA组织化学染色，22例行电镜下观察，统计癌变例数，对CEA染色结果及镜下结构进行分析。结果：本次大肠腺瘤总体检出率为23.9%(3144/13 167)，癌变发生率为1.3%(40/3144)，其中包括管状腺瘤癌变7例，绒毛管状腺瘤癌变10例，绒毛状腺瘤癌变23例；从CEA染色情况来看，正常肠黏膜和炎性息肉之间，正常肠黏膜、炎性息肉和大肠腺瘤之间，大肠腺瘤(管状腺瘤、绒管状腺瘤、绒毛状腺瘤)和癌变组织(腺瘤癌变、腺癌)之间的阳性染色率均存在显著差异(P<0.05)。结论：大肠腺瘤为癌前病变，不同类型的大肠腺瘤的治疗和预后也不尽相同，因此要结合多方面的检查结果进行认真诊断，为临床提供必要依据。
【关键词】 大肠腺瘤； 癌变； 病例； 免疫组织化学
, 百拇医药 【Abstract】 Objective：To investigate and research the clinicopathologic features and immunohistochemical experiments of colorectal adenoma canceration.Method：13 167 patients with fiber colonoscopy in our hospital from January 2013 to December 2014 were selected as research objects，there were 3144 cases of colorectal adenoma，among them，82 cases underwent CEA histochemical staining，22 cases underwent observation under the electron microscope，the cases of cancer were added up，the results of CEA staining and microscopic structure were analyzed.Result：The total detection rate of colorectal adenoma canceration was 23.9% (3144/13 167)，the incidence rate of cancer was 1.3%(40/3144)，including 7 cases of tubular adenoma canceration，10 cases of villous tubular adenoma canceration，villous adenoma in 23 cases，from the CEA staining，there were statistically significant differences in the positive staining rates between normal mucosa and inflammatory polyps，among the normal mucosa，inflammatory polyps and colorectal adenoma，between the colorectal adenoma(tubular adenoma canceration，villous tubular adenoma canceration，villous adenoma) and cancerous tissue(adenoma canceration，adenocarcinoma)(P<0.05).Conclusion：Colorectal adenomas as a precancerous lesion，different types of treatment and prognosis in colorectal adenoma are not the same，therefore，it should be combined with many aspects of the inspection results for serious diagnosis to provide the necessary basis for the clinical.
, 百拇医药
【Key words】 Colorectal adenoma； Canceration； Case； Immunohistochemistry
First-author’s address：Shenyang Coloproctology Hospital，Shenyang 110002，China
doi：10.3969/j.issn.1674-4985.2015.32.045
大肠腺瘤的早期病理诊断是防治大肠腺癌的重要措施，是改善癌症患者预后情况的关键所在[1]。大肠腺瘤的癌变发生率及癌变程度与临床治疗方案有密切相关，因此能否对大肠腺瘤做出准确的病理学诊断，在大肠镜活检中有着重要的意义[2-3]。为了深入了解大肠腺瘤癌变情况及病理特点，笔者进行了相关研究，现报道如下。
1 资料与方法
1.1 一般资料 选取2013年1月-2014年12月在本院行纤维肠镜检查的13 167例患者，共检出大肠腺瘤3144例，其中男2216例，女928例，年龄24～71岁，平均(54.3±19.6)岁。
1.2 检测方法 按照WHO的组织学分类标准，将材料用10%福尔马林固定，常规石蜡包埋切片，HE染色，其中82例行CEA单克隆抗体，酶联葡萄球菌A蛋白，间接法免疫酶标记，22例行电镜下观察。此外选择32例正常肠黏膜、37例炎性息肉和18例腺癌组织作为对照。, http://www.100md.com(王丽华)
【关键词】 大肠腺瘤； 癌变； 病例； 免疫组织化学
, 百拇医药 【Abstract】 Objective：To investigate and research the clinicopathologic features and immunohistochemical experiments of colorectal adenoma canceration.Method：13 167 patients with fiber colonoscopy in our hospital from January 2013 to December 2014 were selected as research objects，there were 3144 cases of colorectal adenoma，among them，82 cases underwent CEA histochemical staining，22 cases underwent observation under the electron microscope，the cases of cancer were added up，the results of CEA staining and microscopic structure were analyzed.Result：The total detection rate of colorectal adenoma canceration was 23.9% (3144/13 167)，the incidence rate of cancer was 1.3%(40/3144)，including 7 cases of tubular adenoma canceration，10 cases of villous tubular adenoma canceration，villous adenoma in 23 cases，from the CEA staining，there were statistically significant differences in the positive staining rates between normal mucosa and inflammatory polyps，among the normal mucosa，inflammatory polyps and colorectal adenoma，between the colorectal adenoma(tubular adenoma canceration，villous tubular adenoma canceration，villous adenoma) and cancerous tissue(adenoma canceration，adenocarcinoma)(P<0.05).Conclusion：Colorectal adenomas as a precancerous lesion，different types of treatment and prognosis in colorectal adenoma are not the same，therefore，it should be combined with many aspects of the inspection results for serious diagnosis to provide the necessary basis for the clinical.
, 百拇医药
【Key words】 Colorectal adenoma； Canceration； Case； Immunohistochemistry
First-author’s address：Shenyang Coloproctology Hospital，Shenyang 110002，China
doi：10.3969/j.issn.1674-4985.2015.32.045
大肠腺瘤的早期病理诊断是防治大肠腺癌的重要措施，是改善癌症患者预后情况的关键所在[1]。大肠腺瘤的癌变发生率及癌变程度与临床治疗方案有密切相关，因此能否对大肠腺瘤做出准确的病理学诊断，在大肠镜活检中有着重要的意义[2-3]。为了深入了解大肠腺瘤癌变情况及病理特点，笔者进行了相关研究，现报道如下。
1 资料与方法
1.1 一般资料 选取2013年1月-2014年12月在本院行纤维肠镜检查的13 167例患者，共检出大肠腺瘤3144例，其中男2216例，女928例，年龄24～71岁，平均(54.3±19.6)岁。
1.2 检测方法 按照WHO的组织学分类标准，将材料用10%福尔马林固定，常规石蜡包埋切片，HE染色，其中82例行CEA单克隆抗体，酶联葡萄球菌A蛋白，间接法免疫酶标记，22例行电镜下观察。此外选择32例正常肠黏膜、37例炎性息肉和18例腺癌组织作为对照。, http://www.100md.com(王丽华)