What is colorectal adenomas? Colorectal adenomas are precancerous lesions, so how timely detection of colorectal disease and to give timely treatment is an important means of preventing colon cancer. Colorectal adenomas without clinical symptoms of disease often can be prompted occasional blood in the stool of patients with of course the relevant inspection. Colorectal neoplasia on several issues worth noting:
1. Colorectal adenoma and colorectal adenomas relationship between the development of early colorectal cancer patients how much time? Currently found in 95% of early colorectal cancer and adenoma is related to colorectal adenomas generally been on, and then is followed by changes to Cancer This process required about 10 years, but severe dysplasia adenomas evolve into early cancer as long as 3-6 years. Adenomas are usually larger in general the higher the probability of cancer, <1cm adenomas cancer rate of <1% ,1-2cm cancerous adenomas was 10%.> 2cm cancerous adenomas is approximately 50%.
2. Colorectal adenoma and gender, age, relationship between the high incidence of male colorectal neoplasia in women, but the incidence of colorectal cancer is almost equal to men and women, even women are also higher than that of men, some people think that women mostly dysplasia adenoma cells, easy occurrence of atypical hyperplasia, which developed into cancer. It was also found that: the site distribution of colorectal neoplasia is closely related to age, age of 60 years of age, adenomas are mainly located in left colon, 60 years old age group, whether adenomas or colorectal cancer, the main located in the right colon. Therefore, over 60 years age groups colonoscopy the entire colon must be checked.
3. Instead of great importance to familial colorectal adenoma patients, their family members should pay attention to familial multiple adenomas, adenomas in the large intestine, more than 100 of these patients before surgery should be the entire colon examination, and must enter the terminal ileum, observed terminal ileum with or without adenoma, the treatment of some help. Patients with gonadal Liubing the family brothers and sisters, children should be regarded as high risk for regular surveillance colonoscopy.
What is colorectal adenomas, 4. Different types of adenoma, cancer rates are different for the colorectal tubular adenoma a benign tumor most common, accounting for 75% -80 adenomas%, the cancer rate of 10 % -15%. Villous adenoma is a rare large intestine adenoma, accounting for 15% of all colorectal adenomas, a higher cancer rate, up to 20% -40%. Mixed tubular adenoma or villous adenoma, usually larger, about 50% larger than 1.5 cm, cancer 30% -40%. Multiple adenomas are often multiple dissemination in various intestinal segments were more than 2 to 100 or less, the majority of cases below 50, generally no significant family history, sometimes clouds one adenoma, associated with bad health or ulcer, necrosis often suggest cancer, cancer rates in 25% -100%.
5. Attention to hyperplastic polyps, adenomatous tumors of the small flat polyps as precancerous lesions is beyond reproach, of hyperplastic polyps to re-understand the past, that the treatment of hyperplastic polyps do not view should be changed. While wary of large adenomas (high due to cancer), but on the small flat adenoma can not be taken lightly, as recently found that the diameter is less than 1em, showed a slight flat elevation, may be associated with central depression, the cancer rate was adenomas larger than normal, it was reported that cancer was 15.8% -41%.
6. Neoplasia biopsy of the right view of the site of cancerous adenomas can be in the top or middle of adenoma body, may also occur in the pedicle or base office. Therefore, the results of biopsy alone to diagnose adenoma have cancer is inaccurate.
7. Colorectal adenomas should be treated regardless of size, histological type, once discovered, should be actively treated, the current line in the high-frequency electrocautery endoscopic removal of the colon, is a key breakthrough in colorectal cancer prevention.
8. Colorectal adenomas can also be used in drug prevention drug to a recent study prevention of colorectal adenomas, more effective drugs currently considered as non-simplified anti-inflammatory drugs, including aspirin, the most common, some people will be 1121 cases with colorectal adenomas history of patients randomized to aspirin 81mg daily or placebo, at least 1 year after taking the drug for colonoscopy followed up the 1084 cases (97%), aspirin adenoma low risk of disease recurrence in the placebo group (38%: 47%); recently also useful Cox-2 inhibitors (celecoxib or rofecoxib) for the treatment observation can also reduce the incidence of colorectal adenomas, but recently found that Cox-2 inhibitors increase the risk of cardiovascular events, affecting the application of the preparation. I have to aspirin for the prevention of hospital observation, daily doses of aspirin 50 mg, a total of more than 100 cases of patients with the placebo group, the result of taking the aspirin group compared with the incidence of colorectal adenomas lower in the placebo group were significantly different between the two groups that aspirin can prevent colorectal adenomas does occur.
What is colorectal adenomas 9. Colorectal neoplasia after removal of adenoma by follow-up after removal of high-frequency electrocautery, the frequency of occurrence of new adenomas in 13% -48% can be missing adenoma. A group of 586 cases of colorectal adenomas removed by high-frequency electrocautery in patients 1 year after operation conventional colonoscopy follow-up examination found that: 20% of patients had new adenomas, 10% of the patients had missing adenoma. Who had a later date with colorectal adenoma risk probability of 16 times higher than the normal population. These patients should therefore be regarded as high risk for regular follow-up colonoscopy. The first follow-up examination no lesions were not completely rule out new or missing adenomas exist. Check for 2 years without lesions, after the check interval of 2 years 1; still no lesions, after an interval of 4 years, 1 check, need lifelong follow-up, the only way to detect adenomas and active treatment, as not to turn into cancer in order to effectively prevent and reduce the incidence of colon cancer.