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FUNDAMENTOS: O estudo dos pólipos, em especial os adenomatosos, é relevante devido à correlação direta com o carcinoma colorretal. Objetivo: Analisar quais são os fatores de risco para uma displasia de alto grau do pólipo adenomatoso retirados endoscopicamente. MÉTODOS: Avaliamos todas as colonoscopias realizadas pelo Serviço de Coloproctologia no período de janeiro de 2003 a dezembro de 2006. Foram incluídos os pacientes com diagnóstico de pólipos adenomatosos. Analisamos a existência da relação entre adenomas com displasia de alto grau e os fatores associados dos pacientes e pólipos. RESULTADOS: Foram realizados 1821 exames e encontramos 208 pacientes com 326 adenomas. 51,4% do sexo masculino e 69,2% tinham um único adenoma. Foram encontrados 28 pacientes (13,5%) com, ao total, 34 adenomas (10,4%), com displasia de alto grau. Entre os adenomas com displasia de alto grau, 64,7% eram = 1cm, 61,8% eram sésseis, 29,4% vilosos e 70,6% estavam localizados no cólon esquerdo. Comparando as características do grupo dos adenomas com displasia de baixo grau com o de alto grau, foi estatisticamente significativo o tamanho = 1cm e o componente viloso (P BACKGROUND: The study of polyps, especially adenomatous, is justified because of the straight correlation among them with the incidence of CRC. Objective: To analyze the risk factors for high-grade dysplasia of adenomatous polyps removed endoscopically. METHODS: All consecutive colonoscopies performed by the Colorectal Department of the Hospital Nossa Senhora da Conceição, in Porto Alegre/RS, from January 2003 to December 2006, were evaluated. Patients diagnosed with adenomatous polyps were included. The relationship among tumors with high-grade dysplasia and the features of the patients and polyps were analyzed. RESULTS: Among the 1,821 exams, 326 adenomas were detected in 208 patients. 51.4% of the patients were male; 69,2% had only one adenoma. A total of 28 patients (13,5%) with 34 adenomas (10,4%) with high-grade dysplasia were found. Among the tumors with high-grade dysplasia, 64.7% were = 1cm, 61.8% were sessile, 29.4% were villous, and 70.6% were located in the left colon. Comparing the characteristics of the group of tumors of low grade dysplasia with those of high-grade, the size = 1cm and villous component (P |
