文章：

恶性直肠息肉的处理——一篇叙述性综述

Management of the Malignant Rectal Polyp—A Narrative Review

原文发布日期：27 April 2025

DOI: 10.3390/cancers17091464

类型: Article

开放获取: 是

英文摘要：

Purpose: The aim of this review is to provide a contemporary update on the current management approaches and options with specific considerations in malignant rectal polyps. Methods: A literature review was carried out in PubMed, Embase and Cochrane databases using the keywords “malignant” and “polyp*”. Only publications in English language were included. Results: Histopathological features including margins, depth of invasion, tumour grade, LVI and tumour budding determines the risk of lymph node metastasis in malignant polyps. Rectal malignant polyps should be considered differently compared to their colonic counterpart. A low threshold should be considered for utilising transrectal excision to fully excise the polyp and to assess the margins. The rates of complete pathological response associated with total neoadjuvant therapy as well as the advent of “watch and wait” adds to the complexity of managing malignant rectal polyps. Conclusions: The management of malignant colorectal polyps lies in risk-stratifying patients who will benefit from an oncological resection.

摘要翻译： 

目的：本综述旨在提供关于恶性直肠息肉当前管理方法及选择的最新进展，并特别关注其特殊性考量。方法：通过PubMed、Embase和Cochrane数据库，使用“恶性”与“息肉*”作为关键词进行文献检索，仅纳入英文出版物。结果：组织病理学特征，包括切缘状态、浸润深度、肿瘤分级、淋巴血管侵犯及肿瘤出芽，决定了恶性息肉淋巴结转移的风险。与结肠恶性息肉相比，直肠恶性息肉的处理需区别对待。应降低采用经直肠切除术以完整切除息肉并评估切缘的决策门槛。全量新辅助治疗带来的完全病理缓解率以及“观察等待”策略的出现，进一步增加了恶性直肠息肉管理的复杂性。结论：恶性结直肠息肉的管理关键在于对患者进行风险分层，以识别那些能从肿瘤学根治性切除术中获益的个体。

原文链接：

Management of the Malignant Rectal Polyp—A Narrative Review