Analysis Of Clinical And Pathological Characteristics Of Colonic Polyps And Related Risk Factors Of Canceration Of Colonic Polyps

Objective:To investigate the clinical and pathological characteristics of colonic polyps and related risk factors of canceration of colonic polyps.Methods:The clinical and pathological data of one hundred patients who underwent polypectomy in the second affiliated hospital of Zhejiang University School of medicine From December 2013 to March 2016 were collected as the group of colonic polyps. Also, the data of twenty-five patients with high grade intraepithelial neoplasia (canceration) were collected. They are divided into the cancer group (n= 31) and non-cancer group (n= 94). At the same time, we collected 100 cases of patients without major diseases as the control group of non-colonic polyps. All the data of colonic polyps group and non-colonic polyps group, the cancer group and non-cancer group were compared and analyzed. Statistical analysis was performed using IBM SPSS 20.0. A P value less than 0.05 were considered as statistical difference.Results:The clinical and pathological characteristics of one hundred patients who underwent polypectomy were as follows:there were 68 male patients and 32 female patients. The average age of the cases was 57.1 years old. The average BMI was 23.67kg/m2. There were 48 patients who had the history of drinking and 45 patients who had the history of smoking.31 patients had hypertension,7 patients had diabetes, 38 patients had been proven to have the fatty liver disease by the ultrasound examination. The data of 239 polyps excised in colonic polyp group were collected. There were 137 tubular adenoma polyps (57.3%),36 hyperplastic polyps (15.1%),51 inflammatory polyps (21.3%),2 juvenile polyps (0.8%),1 serrated adenoma (0.4%),10 tubulovillous adenoma (4.2%), and 2 villous polyps (0.8%). Eight polyps were cancerous (3.3%). Polyps with type Is (n=176,73.6%) was most common. Chi square test showed the risk of occurrence of adenomas in the transverse colon was higher than that of other parts, lower than the other parts in the rectal colon. The risk of occurrence of inflammatory polyps in the rectum and appendix colon in higher than the other parts of the colon. There was no statistic difference between different parts of the colon for the occurrence of hyperplastic polyp. Analysis showed statistic differences between the colonic polyp group and the non-colonic polyp group in gender, the history of smoking, the presence rate of fatty liver disease, age, FBG, WBC, RBC, HB, PLT, CRP, LDL, HDL, TC, apoAl, apoB and UA. Single-factor regression analysis showed that gender, age, the history of smoking, the presence of fatty liver disease and higher UA were the risk factors of occurrence of colonic polyps. Multi-logistic regression analysis indicated that age was the independent risk factor of occurrence of colonic polyps.The average diameter of villous polyp was 2.08cm,1.75cm for the tubularvillous adenoma,0.85cm for the tubular adenoma,0.57cm for the hyperplastic polyp and 0.56cm for the inflammatory polyp. Single factor variance analysis showed that there was no significant difference in the size between hyperplastic polyps and inflammatory polyps, and between tubularvillous adenoma and villous adenoma The difference between the other types of polyps was statistic significant. The risk of canceration for polyps in the sigmoid colon was higher than the other parts of the colon(OR=2.31, P=0.027).Polyps with the type of Ip and Ha had a higher risk to be malignant. Also, tubularvillous adenoma and villous adenoma had a higher risk to be malignant. Analysis showed no statistic differences between cancer group and non-cancer group in general information and blood biochemical indexs. Regression analysis showed that size of the polyps was the risk factors of canceration of colonic polyps, polyps in the rectum,sigmoid colon, descending colon and transverse colon were more easily to be malignant. Tubularvillous adenoma had a higher risk to be malignant.Conclusions:Colonic polyps were more common in the elderly male people. People who had colonic polyps had a higher incidence of hypertension and fatty liver disease. Tubular adenoma was the most common colon polyps. Elderly male patients, the. history of smoking, the presence of fatty liver disease and higher blood uric acid were the risk factors of occurrence of colonic polyps. Age was the independent risk factors of occurrence of colonic polyps. The size, location, type of polyps were the risk factors of canceration of colonic polyps.