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대장 소용종 및 미세용종의 분석 및 임상적 의의

Clinicopathologic Features and Clinical Significance of Small and Diminutive Colorectal Polyps

대한대장항문학회지 2005년 21권 1호 p.6 ~ 12
이숭 ( Lee Soong ) - 서남대학교 의과대학교 내과학교실

김성호 ( Kim Seong-Ho ) - 서남대학교 의과대학 내과학교실
이두영 ( Lee Doo-Young ) - 서남대학교 의과대학 내과학교실
선제형 ( Sun Jae-Hyung ) - 서남대학교 의과대학교 내과학교실
박진석 ( Park Jin-Seok ) - 서남대학교 의과대학교 내과학교실
박주섭 ( Park Ju-Sup ) - 서남대학교 의과대학 외과학교실
양대현 ( Yang Dae-Hyun ) - 서남대학교 의과대학 목포중앙병원
나호영 ( Na Ho-Young ) - 목포 중앙병원 내과
김기태 ( Kim Ki-Tai ) - 목포 중앙병원 내과

Abstract


Purpose: Small (6 to 10 mm) and diminutive colon polyps (below 5 mm) are routinely removed at the time of colonoscopy for the prevention of colon cancer. Our aims in this study were to determine clinicopathologic features and frequency of significant synchronous neoplastic lesions of small colon polyps and diminutive colon polyps and to investigate development of colorectal carcinoma via surveillance colonoscopy.

Methods: We evaluated medical reports of all patients undergoing total colonoscopic examination over a 12-month period. Three hundred thirty nine small colorectal polyps, removed during colonoscopy, have been analyzed. We investigated the result of surveillance colonoscopy, also. Using this database, all adenomas were categorized into two groups: Group I, ≤5 mm diameter (diminutive polyp), Group 2, 6 to 10 mm diameter (small polyp). Significant synchronous adenomas were defined as adenoma over 6 mm diameter, dysplasia or cancer.

Results: The most common age group was the sixth decade. The male-to-female ratio was 2.1:1. Of the small colorectal polyps, 180 (53.1%) were adenomatous, 32 (10.0%) were hyperplastic, 119 (34.9%) were chronic nonspecific inflammation, 3 (0.9 %) were lymphoid hyperplasia, and 4 (1.1%) were cancerous. The most frequent sites of these lesions were rectum and sigmoid (60.2%). Recognizable endoscopic features of polyps were redness (35.8%) and nodule (26.3%). The prevalence of advanced proximal synchronous polyps was 20.7% among patients with distal small lesions.
And we detected 2 cases (25%) had new small polyps in follow up colonoscopic examination.

Conclusions: All polyps should be removed when encountered during colonoscopy due to the higher prevalence of adenoma among these lesions. Effort to find new polyps via surveillance colonoscopy is needed.

키워드

대장; 소용종; 미세용종
Small; Diminutive; Colonic polyps
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