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警惕大肠息肉变肠癌

2018-12-24 17:32:00    新华网

新华社合肥12月24日电(记者鲍晓菁)大肠息肉是指大肠黏膜表面的隆起性病变,大多数位于结肠或直肠,40岁以上人群发病率明显增高。专家提醒,90%以上的大肠癌是一步步从大肠息肉转变过来的,由于很少引起症状,大肠息肉往往不易被发现,因此被忽视。

合肥市一院消化内科主任医师彭琼介绍,小息肉→大息肉→重度不典型增生→原位癌→浸润性癌,这个恶变的过程一般需要5至10年,个体差异不同进展速度存在差异。大肠息肉是否会癌变,与息肉的分型和大小息息相关。常见的大肠息肉分为炎性息肉和腺瘤性息肉,炎性息肉一般不会癌变,由肠道增生性的炎症引起,有时很小的炎性息肉会自行消失。腺瘤性息肉不会自行消退,也不可能用药物将它消除,腺瘤性息肉的恶变概率较高,是学术界公认的癌前病变。而腺瘤直径越大,癌变率越高,超过2cm以上的腺瘤继续发展多半会变成癌。

专家建议,为了早诊断早治疗,体检时不应拒绝相关检查。一旦发现有风险,可以选择在内镜下息肉切除,创伤小、风险小,这是阻断息肉癌变最主要的临床治疗手段。对于部分超过2cm的息肉内镜下也能切除。术后只要按医嘱按时体检即可:进展期腺瘤(腺瘤大于1cm、绒毛状结构或伴高级别瘤变)患者,建议1-3年复查结肠镜,未复发则延长间隔至3-5年;非进展期腺瘤患者2-3年复查结肠镜,未复发则延长间隔至3-5年。

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