Objective To explore the characteristics of the disease spectrum in the pathological diagnoses of biopsy specimens obtained through electronic colonoscopy in clinical application, and to propose a comprehensive strategy for early detection of malignant tumors and precancerous lesions. Methods The pathological diagnosis results of 13,971 electronic colonoscopy examinations conducted at Characteristics Medical Center of Chinese People’s Armed Police Force from July 2014 to August 2024 were extracted. The characteristics of disease spectrum were analyzed, as well as the clinical pathological features such as the location, pathological type, gender and age of precancerous lesions and benign tumors. Results Among the 13,971 cases, the common lesions were benign tumors, inflammatory diseases, malignant tumors and other diseases. The common types of benign tumors were traditional adenomas, serrated lesions and polyps, lipomas, and leiomyomas. The common types of inflammatory diseases were chronic inflammation and inflammatory bowel disease, with significant difference in the composition of affected sites (P<0.0001), and the latter had a higher proportion of multi-site involvement. The common types of malignant tumors were adenocarcinoma, neuroendocrine tumors, lymphoma, and malignant melanoma, among which adenocarcinoma and neuroendocrine tumors were likely to be detected in the left half of the colon. In precancerous lesions, tubular adenomas, tubulovillous adenoma, and villous adenoma were more likely to be detected in the left half of the colon. Compared with young and middle-aged patients, the proportion of multi-site detection of tubular adenomas and traditional serrated adenomas significantly increased in elderly patients, and the difference was statistically significant (P<0.01). Traditional serrated adenomas were more likely to be detected in the left half of the colon in males. Conclusions In the spectrum of pathologically diagnosed diseases based on electronic colonoscopy biopsy, benign tumors are the most common, and precancerous lesions are mostly tubular adenomas, while adenocarcinomas are the most common malignant tumors and are more likely to be detected in the left half of the colon. Different diseases exhibit characteristic differences in age, gender, and location distribution, which can provide reference for early clinical identification and risk stratification.
Key words
electronic colonoscopy /
malignant tumor /
precancerous lesion /
disease spectrum /
screening
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