|本期目录/Table of Contents|

[1]郭天宇,花海洋,李建辉,等.慢性HBV感染者并发结直肠息肉的临床分析[J].国际消化病杂志,2024,03:171-174,195.
 GUO Tianyu,HUA Haiyang,LI Jianhui,et al.Clinical analysis of chronic hepatitis B virus infection complicated with colorectal polyps[J].International Journal of Digestive Disease,2024,03:171-174,195.
点击复制

慢性HBV感染者并发结直肠息肉的临床分析(PDF)

《国际消化病杂志》[ISSN:1673-534X/CN:31-1953/R]

期数:
2024年03期
页码:
171-174,195
栏目:
论著
出版日期:
2024-06-25

文章信息/Info

Title:
Clinical analysis of chronic hepatitis B virus infection complicated with colorectal polyps
作者:
郭天宇花海洋李建辉王爱民
067000 承德医学院第二临床学院(郭天宇), 067000 承德市中心医院消化内科(花海洋、李建辉、王爱民)
Author(s):
GUO TianyuHUA Haiyang LI Jianhui WANG Aimin
GUO Tianyu. The Second Clinical College, Chengde Medical College, Chengde 067000, China;HUA Haiyang, LI Jianhui, WANG Aimin. Department of Gastroenterology, Chengde Central Hospital, Chengde 067000, China
关键词:
HBV 结直肠息肉癌变风险治疗难度
Keywords:
HBV Colorectal polyps Cancer risk Treatment difficulty
分类号:
-
DOI:
10.3969/j.issn.1673-534X.2024.03.007
文献标识码:
-
摘要:
目的分析慢性HBV感染者并发结直肠息肉的内镜下特征及病理特征,探讨其癌变风险及内镜下治疗难度。方法选择2019年1月至2022年12月在承德市中心医院接受内镜下息肉切除治疗的147例患者作为研究对象,将53例合并HBV感染的患者设为HBV组,将94例无HBV感染的患者设为对照组。收集患者的基本信息,以及入院血清癌胚抗原(CEA)检测、内镜和病理检查结果等资料。比较2组各肠段的息肉检出率、内镜下特征及病理特征、内镜下治疗时间、术中和术后出血率、血清CEA水平。结果HBV组的直肠息肉检出率显著高于对照组(43.40%比25.53%,P=0.026)。HBV组的息肉最大径、息肉数目、息肉带蒂率、内镜下治疗时间、术中出血率和血清CEA水平均显著高于对照组(P均<0.05)。HBV组的腺瘤性和癌性息肉发生率显著高于对照组(92.45%比70.21%,P=0.002)。结论与一般人群相比,慢性HBV感染并发结直肠息肉患者的直肠息肉检出率较高;病理检查结果多为腺瘤性或癌性息肉,息肉的癌变风险较高;息肉多数较大、带蒂且多发,术中出血率较高,内镜下治疗难度和并发症发生风险均较高,建议早期筛查。
Abstract:
Objective? This paper intends to analyze the endoscopic and pathological characteristics of colorectal polyps in patients with chronic HBV infection, and explore their cancer risk and difficulty in endoscopic treatment. Methods? A hundred and forty-seven patients who underwent endoscopic polypectomy at Chengde Central Hospital from January 2019 to December 2022 were selected as the study subjects. Fifty-three patients with HBV infection were assigned to the HBV group, and ninety-four patients without HBV infection were assigned to the control group. The basic information of the patient, as well as data on serum carcinoembryonic antigen (CEA) testing, endoscopic, and pathological examination results upon admission, were collected. The polyp detection rate, endoscopic and pathological characteristics, endoscopic treatment time, intraoperative and postoperative bleeding rates, and serum CEA levels of each intestinal segment in two groups were compared. Results? The detection rate of rectal polyps in the HBV group is significantly higher than that in the control group (43.40% versus 25.53%, and P=0.026). The maximum diameter, number, pedicle rate, endoscopic treatment time, intraoperative bleeding rate, and serum CEA level of the HBV group are significantly higher than those of the control group (P<0.05). The incidence of adenomatous polyps and cancerous polyps in the HBV group is significantly higher than that in the control group (92.45% versus 70.21%, and P=0.002). Conclusions? Compared with the general population, patients with chronic HBV infection complicated by colorectal polyps have a higher detection rate of rectal polyps. The pathological examination results are mostly adenomatous polyps or cancerous polyps, which have a higher risk of cancerous transformation. Polyps are often large, pedicled, and frequent, with a high intraoperative bleeding rate. Endoscopic treatment is difficult and the risk of complications is high. Early screening is recommended.

参考文献/References

1 尤红, 王福生, 李太生, 等. 慢性乙型肝炎防治指南(2022年版) [J]. 实用肝脏病杂志, 2023, 26(3): 457-478.
2Li M, Gan Y, Fan C, et al. Hepatitis B virus and risk of non‐Hodgkin lymphoma: An updated meta‐analysis of 58 studies[J]. J Viral Hepat, 2018, 25(8): 894-903.
3 中华医学会肿瘤学分会, 国家卫生健康委员会医政司. 中国结直肠癌诊疗规范(2023版)[J]. 协和医学杂志, 2023, 14(4): 706-733.
4Hong SW, Choi WM, Hwang HW, et al. Chronic viral hepatitis is associated with colorectal neoplasia: A systematic review and meta-analysis[J]. Dig Dis Sci, 2021, 66(11): 3715-3724.
5 中国抗癌协会, 中国抗癌协会大肠癌专业委员会. 中国恶性肿瘤整合诊治指南-直肠癌部分[J]. 中华结直肠疾病电子杂志, 2022, 11(2): 89-103.
6 中华医学会病理学分会消化疾病学组. 胃肠道腺瘤和良性上皮性息肉的病理诊断共识[J]. 中华病理学杂志, 2020, 49(1): 3-11.
7Min Y, Wei X, Xia X, et al. Hepatitis B virus infection: An insight into the clinical connection and molecular interaction between hepatitis B virus and host extrahepatic cancer risk[J]. Front Immunol, 2023, 14: 1141956.
8Liu T, Song C, Zhang Y, et al. Hepatitis B virus infection and the risk of gastrointestinal cancers among Chinese population: A prospective cohort study[J]. Int J Cancer, 2022, 150(6): 1018-1028.
9Kim SH, Kim JW, Lee KL, et al. Hepatitis B virus infection is independently associated with advanced colorectal adenoma[J]. Am J Med Sci, 2018, 356(2): 141-146.
10 Jung YS, Kim NH, Park JH, et al. Correlation between hepatitis B virus infection and colorectal neoplasia[J]. J Clin Med, 2019, 8(12):2085.
11 钱熠辉, 彭琼. 乙型肝炎病毒感染与结直肠腺瘤的相关性研究[J].医学信息, 2019, 32(4): 81-84.
12 刘林霞, 马洁云, 田晓锋. 预先蒂部结扎辅助高频电切除术治疗消化道带蒂息肉的临床效果[J]. 实用临床医药杂志, 2019, 23(7):84-86.

备注/Memo

备注/Memo:
通信作者:王爱民,Email: 173451424@qq.com
更新日期/Last Update: 2024-06-25