Comparative study of the characteristics of polypoid lesions between the left and right colons

YANG Xue; LIU Pei-xi; XIAO Xun; CHEN Zi-yang

doi:10.3969/j.issn.1001-9448.2018.05.010

Abstract：Objective To compare the characteristics of polypoid lesions between the left and right colons. Methods Totally 2392 colon polypoid lesions were analyzed. The left and the right colons were defined according to the demarcation of splenic flexure. Pathological types of polypoid lesions, age, gender, size and degree of dysplasia were analyzed. Results The pathological types included adenomatous polyp, hyperplastic polyp, inflammatory polyp, retention polyp, neuroendocrine tumor and spindle cell tumor. The pathological subtypes of adenomatous polyps included tubular adenoma, tubular villous adenoma, villous adenoma, and serrated adenoma. Polypoid lesions were more often detected in the left colon than the right colon (64. 92％ vs. 35. 08％). Adenomatous polyp was the most common type (84. 50％). The distribution of pathological types between the left and right colons was different (P ＜ 0. 05). Being different from other pathological types, adenomatous polyps in both the left and right colons significantly increased with the age after 40, especially in the left colon (P ＜ 0. 05). Serrated adenomas were more common detected in male patients and the left colon (P＜ 0. 05). Adenomatous polyps in the left colon were significantly larger than those in the right (P ＜ 0. 05), while hyperplastic polyps were smaller (P ＜ 0. 05). Severe dysplasia and early carcinomas were more common detected in the left colon (P ＜ 0. 05). Other than severe dysplasia and early carcinoma, adenomatous polyps with moderate dysplasia in the right colon were smaller than those in the left (P ＜ 0. 05). Conclusion The pathology, age, gender, size and degree of dysplasia of the polypoid lesions are different between the left and right colons. More malignant changes occur in adenomatous polyps in the left colon. In the right colon, adenomatous polyps with moderate dysplasia probably grow faster when they develop to severe dysplasia and early carcinoma. These clinical features are benefit to the diagnosis and treatment of polypoid lesions under endoscopy.