Intestinal polyps are abnormal growths of tissue protruding from the surface of the intestinal mucosa and are collectively referred to as polyps until their pathological nature is determined. In general, intestinal polyps are benign lesions that can be as small as a sesame seed or a green bean or as large as a walnut. The number can vary from one to hundreds or thousands. In terms of shape, there are tipped polyps, subtibial polyps, and flat polyps. Since it is a benign lesion, why do doctors call it a “time bomb” in the body? The reason is that intestinal polyps have the risk of cancer.
What is the size and type of intestinal polyp cancer prevention?
According to their pathological nature, intestinal polyps can be divided into five categories, including neoplastic, inflammatory, malignant, and proliferative. Among them, neoplastic, i.e. tumorigenic, mainly refers to intestinal adenoma, which is the most common among intestinal polyps, accounting for about 70%-70%, and is the most harmful to the body because it has the possibility of cancer (according to statistics, the cancer rate of single intestinal adenoma is about 5%). A study in the United States showed that about 1% of polyps <1cm in diameter are malignant, 46% of adenomas larger than 2cm are malignant, and only 10% of adenomas between 1 and 2cm are malignant. Adenomas and other cancerous lesions are like “time bombs”. If it is a precancerous lesion such as adenoma, it is equivalent to a “time bomb”, as the polyp increases, the number increases, and the chance of cancer increases rapidly. Even inflammatory polyps, although less harmful to the body, but with the increase of polyps, may also bring a series of clinical symptoms, such as long-term blood in the stool, diarrhea, intestinal overlap and even intestinal obstruction. Can we rely on colonoscopy to determine whether a polyp is good or bad? Generally speaking, polyps with tips, less than 2cm in diameter, smooth surface and good mirror pushing activity are often benign, including inflammatory and adenomatous polyps. In contrast, flattened submucosal polyps with larger diameters (>2 cm), bleeding and ulcers on the surface, and poor mirror propulsion activity tend to have a higher chance of malignancy.
In addition, with the help of techniques such as pigmented endoscopy and magnifying endoscopy, a preliminary determination of the type and nature of the lesion can be made based on the type of glandular duct opening on the surface of the polyp. Of course, endoscopy can only make a general and vague diagnosis based on the shape of the polyp. The correct treatment is to remove the polyp completely and send it for pathological examination to finally determine the nature of the polyp. Pathological results are the “gold standard” for polyp diagnosis. Before the pathological examination, all the diagnosis is just a guess, and it is a “time bomb” if it is not removed and left in the body. Therefore, intestinal polyps should be removed when they are found.
With the development of medical technology, nowadays, most of the colon polyps can be removed without surgery. In recent decades, with the introduction of fiberoptic endoscopy, especially electronic endoscopy, endoscopic technology has developed rapidly, especially the fastest development of endoscopic treatment technology, endoscopic polypectomy is a very mature treatment method. The indications are: 1) polyps and adenomas of various sizes; 2) non-tipped polyps and adenomas less than 2 cm in diameter; 3) multiple adenomas and polyps with scattered distribution and small numbers.
It can be said that endoscopic resection of intestinal polyps has become a routine method for the treatment of intestinal polyps, except for a very small number of cases with excessive diameter, obvious malignant morphology or excessive number, generally the intestinal polyps can be removed completely under endoscopy.