Clinical analysis of 76 patients with colorectal high grade intraepithelial neoplasia diagnosed by colonoscopic biopsy
10.3760/cma.j.issn.0254-1432.2017.02.003
- VernacularTitle:经结肠镜活组织检查诊断为结直肠高级别上皮内瘤变76例的临床分析
- Author:
Wei LIU
;
Jin WANG
;
Hong WANG
;
Xiangyu CHEN
;
Jiansheng LI
;
Shuai LYU
- Keywords:
High grade intraepithelial neoplasia;
Colonoscopic biopsy;
Invasive carcinoma;
Computed tomography
- From:
Chinese Journal of Digestion
2017;37(2):84-87
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze colonoscopic appearances,computed tomography (CT) imaging features and their correlation with postoperative pathology in patients with colorectal high grade intraepithelial neoplasia (HGIN) diagnosed by colonoscopic biopsy.Methods From October 2009 to October 2015,patients diagnosed as colorectal HGIN by colonoscopic biopsy who received endoscopic resection or operation,and had complete postoperative pathological data were enrolled.The results of CT imaging before operation,postoperative pathological type,the maximum diameter of lesions,sessile lesions or pedunculated lesions and enlarged lymph nodes were analyzed.Chi-square test were performed for statistical analysis.Sensitivity and specificity of CT imaging before operation in the detection of invasive colorectal cancer were calculated.Results Among the 76 patients,21.1％ (16/76) patients were HGIN,and 78.9％ (60/76) were invasive cancer confirmed by postoperative pathology.The incidence rate of invasive carcinoma in patients aged ≤50 years (3/14) was significantly lower than that of patients aged ＞50 years (91.9％,57/62),and the difference was statistically significant (x2 =30.05,P＜0.01).The incidence rate of invasive carcinoma in protruding lesions with maximum diameter ≥ 3.0 cm was 98.3％ (57/58),which was higher than that of lesions with maximum diameter ＜3.0 cm(2/16),and the difference was statistically significant (x2 =51.91,P＜0.01).The incidence rate of invasive carcinoma in pedicle polyps group (2/13) was lower than that of sessile lesions (93.4％,57/61),and the difference was statistically significant (x2 =35.72,P＜0.01).The sensitivity and specificity of CT in the diagnosis of invasive colorectal cancer was 95.0％ and 84.6％,respectively.The incidence rate of invasive carcinoma in patients with enlarged lymph nodes detected by CT (93.3 ％,42/45) was significantly higher than that of patients without enlarged lymph nodes (64.3％,18/28),and the difference was statistically significant (x2=9.95,P =0.002).Conclusions CT examination can compensate for the diagnostic deficiency of colonoscopic biopsy which inadequately diagnosed some invasive carcinoma as HGIN.The incidence of invasive cancer is high in patients with age over 50 years,large lesions,sessile lesions,CT indicating colorectal neoplasms and with enlarged lymph nodes.
