发现息肉，离癌有多近？

中都可以发掘出，最少用于40-50岁彼此之间。

小于10毫米的上皮细胞肥大，大约有25%可能亦会直接消退[18]，而且就越小就越非常容易销声匿迹，可能亦会在几次月经早些后随着上皮细胞的剥脱销声匿迹。

多半数内膜上皮细胞肥大是良普遍性的，只有大约0%-12.9%的内膜上皮细胞肥大有恶变可能亦会[21,22]。

通常，绝经之前特别注意到的内膜上皮细胞肥大恶变后果较差，绝经后特别是常有阴囊囊肿的恶变后果较更高。

此外，更高龄、肥胖、更高血压、肥大大小（>15mm）、使用激素替代疗法等也是更高危因素所，因此，一般才亦会要求病人[21,22]。

今天我们明白了，不是所有肥大才亦会皮肤癌。

不间断卫生核查，生物学对待肥大，遵从专科精神科的要求，就是对我们很好的卫生保障！

解题研究者

更高鹏骥| 北京积水潭诊所普通外科外科医生

刘海防| 复旦大学附属机构华山诊所妇产科副外科医生

王东| 北京大学人民诊所肝胆外科外科医生

曲牟文| 中国中医科所学院广安门诊所肛乳科外科医生

参考文献

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[2]Tanaka S, Saitoh Y, Matsuda T, Igarashi M, Matsumoto T, Iwao Y, Suzuki Y, Nozaki R, Sugai T, Oka S, Itabashi M, Sugihara KI, Tsuruta O, Hirata I, Nishida H, Miwa H, Enomoto N, Shimosegawa T, Koike K. Evidence-based clinical practice guidelines for management of colorectal polyps. J Gastroenterol. 2021 Apr;56(4):323-335. doi: 10.1007/s00535-021-01776-1. Epub 2021 Mar 12. PMID: 33710392; PMCID: PMC8005396.

[3]Shussman N, Wexner SD. Colorectal polyps and polyposis syndromes. Gastroenterol Rep (Oxf). 2014;2(1):1-15. doi:10.1093/gastro/got041

[4] Kim NH，Jung YS，Park JH，et al.Risk of developing metachronous advanced colorectal neoplasia after colonoscopic polypectomy in patients aged 30 to 39 and 40 to 49 years［J］.Gastrointest Endosc，2018，88（4）：71 5.

[5]黄浦区抗癌协亦会,复旦大学附属机构癌诊所. 岛民少用癌乙型肝炎和传染病推荐[J]. 卫生指南,2019(6):48-49.

[6]Provenzale D, Gupta S, Ahnen D J, et al. NCCN guidelines insights: colorectal cancer screening, version 1.2018[J]. Journal of the National Comprehensive Cancer Network, 2018, 16(8): 939-949.

[7]Song M, Emilsson L, Roelstraete B, Ludvigsson JF. Risk of colorectal cancer in first degree relatives of patients with colorectal polyps: nationwide case-control study in Sweden. BMJ. 2021 May 4;373:n877. doi: 10.1136/bmj.n877. PMID: 33947661; PMCID: PMC8083372.

[8]Colorectal cancer screening (PDQ) — Health professional version. National Cancer Institute. Accessed Feb. 18, 2022.

[9]Chen C Y, Lu C L, Chang F Y, et al. Risk factors for gallbladder polyps in the Chinese population[J]. American Journal of Gastroenterology (Springer Nature), 1997, 92(11).

[10]Xu A, Hu H. The gallbladder polypoid-lesions conundrum: moving forward with controversy by looking back[J]. Expert Rev Gastroenterol Hepatol, 2017, 11(11):1071-1080

[11]刘凯,卢逸,木斯他巴·买买提热依木,窦宁馨,荣男模,林楠,荣象山.消化道肥大的集病变外科手术指征先直觉——388例消化道摘除术回顾普遍性研究[J].中华肝脏外科外科手术学电子杂志,2021,10(02):147-152.

[12]Wiles R, Thoeni RF, Barbu ST, et al. Management and follow-up of gallbladder polyps : Joint guidelines between the European Society of Gastrointestinal and Abdominal Radiology (ESGAR), European Association for Endoscopic Surgery and other Interventional Techniques (EAES), International Society of Digestive Surgery - European Federation (EFISDS) and European Society of Gastrointestinal Endoscopy (ESGE). Eur Radiol. 2017;27(9):3856-3866. doi:10.1007/s00330-017-4742-y

[13]Foley KG, Lahaye MJ, Thoeni RF, Soltes M, Dewhurst C, Barbu ST, Vashist YK, Rafaelsen SR, Arvanitakis M, Perinel J, Wiles R, Roberts SA. Management and follow-up of gallbladder polyps: updated joint guidelines between the ESGAR, EAES, EFISDS and ESGE. Eur Radiol. 2021 Dec 17. doi: 10.1007/s00330-021-08384-w. Epub ahead of print. PMID: 34918177.

[14]Schnatz PF,Ricci S, O′Sullivan DM．Cervical polyps in postmenopausal women:is there a difference in risk? [J]． Menopause,２ ００ ９,１ ６(３):５ ２４-５ ２ ８．

[15]Stamatellos I, Stamatopoulos P, Bontis J．The role of hysteroscopy in the current management of the cervical polyps [J]．Arch Gynecol Obstet,２ ００ ７,２ ７ ６(４):２ ９ ９-３ ０ ３．

[16]Tanos V, Berry KE, Seikkula J, Abi Raad E, Stroulis A, Sleiman Z, Campo R, Gordts S. The management of polyps in female reproductive organs. Int J Surg. 2017 Jul;43:7-16. doi: 10.1016/j.ijsu.2017.05.012. Epub 2017 May 5. PMID: 28483662.

[17]Alkilani YG, Apodaca-Ramos I. Cervical Polyps. [Updated 2021 Sep 9]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from:

[18]McIlwaine P, McElhinney B, Karthigasu K A, et al. A prospective study of the use of the M yosure resectoscope to manage endometrial polyps in an outpatient setting[J]. Australian and New Zealand Journal of Obstetrics and Gynaecology, 2015, 55(5): 482-486.

[19]McIlwaine P, McElhinney B, Karthigasu K A, et al. A prospective study of the use of the M yosure resectoscope to manage endometrial polyps in an outpatient setting[J]. Australian and New Zealand Journal of Obstetrics and Gynaecology, 2015, 55(5): 482-486.

[20]Antunes Jr A, Costa-Paiva L, Arthuso M, et al. Endometrial polyps in pre-and postmenopausal women: factors associated with malignancy[J]. Maturitas, 2007, 57(4): 415-421.

[21]Nijkang NP, Anderson L, Markham R, Manconi F. Endometrial polyps: Pathogenesis, sequelae and treatment. SAGE Open Med. 2019 May 2;7:2050312119848247. doi: 10.1177/2050312119848247. PMID: 31105939; PMCID: PMC6501471.

[22]American Association of Kim NH，Jung YS，Park JH，et al.Risk of developing metachronous advanced colorectal neoplasia after colonoscopic polypectomy in patients aged 30 to 39 and 40 to 49 years［J］.Gastrointest Endosc，2018，88（4）：71 5.. AAGL practice report: practice guidelines for the diagnosis and management of endometrial polyps. J Minim Invasive Gynecol. 2012 Jan-Feb;19(1):3-10. doi: 10.1016/j.jmig.2011.09.003. PMID: 22196255.

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