ABSTRACT
Objective To investigate the characteristics of the colon polyp in a northwest district of China. Methods 112 cases of patients from 1~18 years old, diagnosed with polyps by means of colonoscopies reference centers were followed-up from January 2015 to December 2016. The clinical variables evaluated in this study included: gender, age, symptoms, age at onset of symptoms, age at identification of the polyp, interval of time between the onset of symptoms and the endoscopic diagnosis of colonic polyps, and family history of colon polyp and/or colorectal cancer. The characteristics of the polyps also included: number, morphological type, diameter, histology, and distribution. The case records of these patients were reviewed. The demographics, clinical course, laboratory results, endoscopic and histopathological features, treatments, and outcomes were analyzed. Results In the 112 patients, the median age was 6.9 years, of which 64.3% (72/112) were male. All the patient had the symptom of hematochezia and just a little of the patients have the symptoms of abdominal pain, prolapse of anal polyp and diarrhea. 9.8% (11/112) was mild anemia and the anemia patient all had the symptom of hematochezia of more than 6 months and have no connection with the polyp location. Juvenile polyps were identified in 91.9% (103/112) patients, inflammatory polyp were identified in 7.1% (8/112) and 0.9% (1/112) were identified with adenoma. 1.8% (2/112) of the patient had the family history of colorectal polyp. Conclusions The morbidity of colorectal polyp in children and adolescents in our region is high. The male was significantly more common seen than female. A little proportion of the patient had the family history of colorectal polyp. The hematochezia could be seen in all patients A little proportion of the patient was mild anemia and the anemia patient all had the symptom of hematochezia of more than 6 months. Mainly the polyp was located in the rectum and sigmoid. Juvenile polyps were the major pathologic type and then the inflammatory polyp and adenoma. The adenoma may located in other place than rectum and sigmoid.
ABSTRACT
<p><b>BACKGROUND</b>The specificity and precision of lymphadenopathy assessment using US, CT and MRI are generally unsatisfactory, while fluorodeoxyglucose-positron emission tomography/computed tomography ((18)F-FDG PET/CT) can support this process by providing additional information about the lymph node features. However, which image features of (18)F-FDG PET/CT play the key role in the diagnosis and cutoffs of malignant cervical lymphadenopathy still needs to be determined by further studies. Our study aimed to identify (18)F-FDG PET/CT abnormalities that would assist in making a reliable diagnosis of malignant cervical lymphadenopathy in enlarged cervical lymph nodes of patients with unknown primary diseases.</p><p><b>METHODS</b>One hundred and ninety-one consecutive patients of cervical lymphadenopathy with unknown primary causes were examined by (18)F-FDG PET/CT from May 2007 to October 2011 and a definite diagnosis was established by pathologic biopsy. (18)F-FDG PET/CT images were evaluated to identify the relevant abnormalities. All image features were analyzed by optimal scale regression tests to determine the important factors that were predictive for the diagnosis of malignant cervical lymphadenopathy and the cutoffs.</p><p><b>RESULTS</b>The factors studied in (18)F-FDG PET/CT images for predicting malignant cervical lymphadenopathy were sex, age, node location, size, shape, margins, maximum standard uptake value (SUV), mean SUV, FDG uptake pattern and number of nodes. It was found that mean SUV, maximum SUV, FDG uptake pattern, location, size and margins were the important risk factors of cervical lymph nodes that could predict malignant cervical lymphadenopathy. Signs of mean SUV ≥ 2.5 (or maximum SUV ≥ 3.5), nodular FDG uptake pattern, location of IIA, III, IV, VB, VI and VII regions, size ≥ 1.5 cm and vague margins had their optimal diagnostic accuracy (Ac) and Youden index (YI), further, combination of any three factors of these six important risk factors would led to the best diagnostic Ac of 96% and YI of 0.93.</p><p><b>CONCLUSIONS</b>Signs of mean SUV, maximum SUV, FDG uptake pattern, location, size and margins of node in (18)F-FDG PET/CT imaging are important predictive factors of malignant cervical lymphadenopathy. A combination of multiple factors may yield a higher diagnostic efficacy.</p>