Analysis of risk factors related to colorectal polyps
ZHANG Qian1 REN Junyao1 XING Jie1 SUN Xiujing1 YUE Bing2 ZHU Shengtao1 LI Peng1 ZHANG Shutian1
1.Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University National Clinical Research Center for Digestive Disease Beijing Digestive Disease Center Beijing Key Laboratory for Precancerous Lesion of Digestive Disease, Beijing 100050, China;
2.Department of Pathology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
Abstract:Objective To explore the risk factors of colorectal polyps found in colonoscopy. Methods A retrospective analysis of 662 patients who underwent colonoscopy at the Digestive Endoscopy Center of Beijing Friendship Hospital, Capital Medical University from March 2013 to November 2014. According to the results of endoscopic and pathological diagnosis, a total of 255 patients with colorectal polyps were included in the polyp group, and 407 subjects with normal results or inflammatory lesions were included in the control group. The age, gender, personal history, past history and other factors of patients were collected, and the related risk factors that affect the occurrence of colorectal polyps were analyzed. Results Age, body mass index (BMI), proportion of males, proportion of light physical labor, smoking rate, alcohol consumption, prevalence of hypertension and previous prevalence of polyps of the polyp group were higher than those of the control group, and the differences were statistically significant (P < 0.05). Multivariate logistic regression model analysis showed that age (OR = 1.050), BMI (OR = 1.059), smoking (OR = 2.359), alcohol (OR = 1.644) and history of previous polyps (OR = 1.758) were independent risk factors for colorectal polyps (P < 0.05); age (OR = 1.049), male (OR = 0.381), smoking (OR = 1.784), and history of polyps (OR = 2.301) were independent risk factors for multiple colorectal polyps (P < 0.05). Conclusion Age, gender, BMI, smoking, drinking, and history of polyps may be independent risk factors for the occurrence or occurrence of colorectal polyps. Therefore, when performing colonoscopy, attention should be paid to comprehensively considering the relevant risk factors of patients, and focusing on screening and follow-up of high-risk groups to improve the detection rate of adenomas.
[1] 中国结直肠癌诊疗规范(2020年版)[J].中国实用外科杂志,2020,40(6):601-625.
[2] Weitz J,Koch M,Debus J,et al. Colorectal cancer [J]. Lancet,2005,365(9454):153-165.
[3] Gupta S,Jacobs ET,Baron JA,et al. Risk stratification of individuals with low-risk colorectal adenomas using clinical characteristics:a pooled analysis [J]. Gut,2017,66(3):446-453.
[4] 黄丹,朱雄增,盛伟琪.2019版《WHO消化系统肿瘤分类》胃肠上皮性肿瘤部分解读[J].中华病理学杂志,2020, 49(3):209-213.
[5] Azer SA. Challenges Facing the Detection of Colonic Polyps:What Can Deep Learning Do? [J]. Medicina (Kaunas),2019,55(8):473.
[6] Singh R,Zorrón Cheng Tao Pu L,Koay D,et al. Sessile serrated adenomapolyps:Where are we at in 2016? [J] World J Gastroenterol,2016,22(34):7754-7759.
[7] Ines M,Helsingen LM,Bretthauer M,et al. Epidemiology and risk factors of colorectal polyps [J]. Best Pract Res Clin Gastroenterol,2017,31(4):419-424.
[8] Park DI,Kim YH,Kim HS,et al. Diagnostic yield of advanced colorectal neoplasia at colonoscopy,according to indications:an investigation from the Korean Association for the Study of Intestinal Diseases (KASID) [J]. Endoscopy,2006,38(5):449-455.
[9] 胡思思,余颖聪,林晓晓,等.非酒精性脂肪肝与结直肠腺瘤性息肉发病相关性分析[J].数理医药学杂志,2019, 32(9):1278-1280.
[10] Edoardo B,Simona I,Vincenzo B,et al. Smoking and colorectal cancer:a meta-analysis [J]. JAMA,2008,300(23):2765-2778.
[11] Edoardo B,Simona I,Sara R,et al. Cigarette smoking and adenomatous polyps:a meta-analysis [J]. Gastroenterology,2007,134(2):388-395.
[12] Fu Z,Shrubsole MJ,Li G,et al. Interaction of cigarette smoking and carcinogen-metabolizing polymorphisms in the risk of colorectal polyps [J]. Carcinogenesis,2013,34(4):779-786.
[13] Bailie L,Loughrey MB,Coleman HG. Lifestyle Risk Factors for Serrated Colorectal Polyps:A Systematic Review and Meta-analysis [J]. Gastroenterology,2017,152(1):92-104.
[14] Zhu JZ,Wang YM,Zhou QY,et al. Systematic review with meta-analysis:alcohol consumption and the risk of colorectal adenoma [J]. Aliment Pharmacol Ther,2014, 40(4):325-337.
[15] 束涛,戴夫,彭琼.结直肠腺瘤性息肉的相关危险因素分析[J].齐齐哈尔:齐齐哈尔医学院学报,2018,39(13):1529-1532.
[16] Keum N,Giovannucci E. Global burden of colorectal cancer:emerging trends,risk factors and prevention strategies [J]. Nat Rev Gastroenterol Hepatol,2019,16(12):713-732.
[17] He X,Wu K,Ogino S,et al. Association Between Risk Factors for Colorectal Cancer and Risk of Serrated Polyps and Conventional Adenomas [J]. Gastroenterology,2018,155(2):355-373.
[18] Johnson CM,Wei C,Ensor JE,et al. Meta-analyses of colorectal cancer risk factors [J]. Cancer Causes Control,2013,24(6):1207-1222.
[19] 江小丽,钟劢文,何惠平,等.高脂血症与结直肠息肉相关性的临床观察[J].中国实用医药,2017,12(15):74-75.
[20] Kim TJ,Kim JE,Choi YH,et al. Obesity-related parameters and colorectal adenoma development [J]. J Gastroenterol,2017,52(12):1221-1229.
[21] 安俊平,刘彬,师艾丽,等.结肠息肉的临床病理特征及其与癌变的相关分析[J].中国医师杂志,2017,19(7):1035-1037.
[22] Birks J,Bankhead C,Holt TA,et al. Evaluation of a prediction model for colorectal cancer:retrospective analysis of 2.5 million patient records [J]. Cancer Med,2017, 6(10):2453-2460.
[23] Freedman AN,Slattery ML,Ballard-Barbash R,et al. Colorectal cancer risk prediction tool for white men and women without known susceptibility [J]. J Clin Oncol,2009,27(5):686-693.
[24] Murchie B,Tandon K,Hakim S,et al. A New Scoring System to Predict the Risk for High-risk Adenoma and Comparison of Existing Risk Calculators [J]. J Clin Gastroenterol,2017,51(4):345-351.
[25] Brazer SR,Pancotto FS,Long TT,et al. Using ordinal logistic regression to estimate the likelihood of colorectal neoplasia [J]. J Clin Epidemiol,1991,44(11):1263-1270.
[26] 韩玉胜,龚志辉,肖泽泉,等.结肠腺瘤性息肉上皮内瘤变例分析[J].世界最新医学信息文摘,2015,15(64):85,87.
[27] 陈月,汪元浚.结肠息肉切除术后复发相关因素研究进展[J].世界最新医学信息文摘,2019,19(66):125-126.
[28] 杨金炉.内镜下结肠息肉切除术后并发出血的危险因素分析[J].中国当代医药,2020,27(4):83-85.
[29] 陶雪娥,覃立行.结直肠腺瘤性息肉内镜下切除后复发的危险因素分析[J].现代消化及介入诊疗,2015,20(3):233-234.