| Objective To summarize and analyze the clinical and pathological features of colorectal polyp,and study the related factors of canceration.Methods 2171 patients with colorectal polyps in the Affiliated Hospital of Qingdao University were analyzed retrospectively.They were divided into low-grade neoplastic group,high-grade neoplastic group and canceration group to analysis the basic characteristics;The low-grade neoplastic group and high-grade neoplastic group were combined into polyp group,and the serological indexes and BMI were analyzed;4075polyps were obtained and divided into non neoplastic group,low-grade neoplastic group,high-grade neoplastic group and canceration group.The pathological characteristics of polyps were statistically analyzed.Results There were significant differences in gender,age,cancer operation history,smoking history,drinking history and polyp number among different case groups(P<0.05),The proportion of men in the high grade neoplastic group was significantly higher than that in the low grade neoplastic group(76.1% vs 63.1%).In the canceration group,the proportion of people aged 60 or older was 76.1%,which was significantly higher than that in the low grade neoplastic group(59.7%),and the proportion of canceration group in each age group increased with age(3.4% 20.5% 76.1%);The proportion of men with smoking history in high-grade neoplastic group and canceration group was 56.6% and 45.5% respectively,which was significantly higher than that in low grade neoplastic group(43%);The number of polyps in canceration group was mostly appeared as 2～4(45.9%).There were significant differences in LDL-C,TC,TG,ALP,CEA,BMI and NLR between canceration group and polyp group(P < 0.05);LDL-C,CEA and NLR were independent risk factors for colorectal polyp canceration;The AUC of LDL-C was 0.5778(95% CI 0.5445～0.6111,P < 0.0001),and<2.435 was the best cut-off value;The AUC of CEA was 0.7306(95% CI 0.6992 ～ 0.7619,P < 0.0001),and>2.685 was the best cutoff value;The AUC of NLR was 0.6947(95% CI0.6631～0.7263,P < 0.0001),and>2.215 was the best cutoff value;Although the AUC of combined diagnosis was 0.6734,there was no significant improvement,but the sensitivity was significantly increased(88.03%).There were statistically significant differences in whether to divide leaves,and also in distribution,diameter,shape and surface condition of polyps in different pathological groups(P<0.05).The lobulation rate of canceration group(69.1%)was significantly higher than that of other groups(0.2%,2.2%,26.4%).In cancer group,polyps were mainly distributed in rectum(35.5%)and sigmoid colon(25.6%).The proportion of polyp with a diameter of 1 cm or more in canceration group was 97.8%,which was significantly higher than that in other groups(8.3%,27.9%,89.6%).In the canceration group,the main manifestations of polyp were sessile(92%).The proportion of patients without pedicle was 92%,which was significantly higher than that of other groups(85.9%,68.1%,43.2%);The mucosal surface was mostly erosive ulcer(61.4%)and rough(33.9%);.There were statistically significant differences in histopathological types of polyps in different grade of neoplasia groups(P<0.05),tubular adenoma(80.5%)was most common in the low-grade neoplastic group,and tubular villous adenoma(63.2%)was most common in the high-grade neoplastic group.Conclusion Men over 44 years old with smoking history have a high risk of high-grade neoplasia or cancer,and the canceration rate increases significantly with age.Besides,lower blood LDL-C,higher CEA,and NLR are also high-risk factors for colorectal polyp canceration.Endoscopic polyps with diameter ≥1cm,lobed,sessile,rectum or sigmoid colon,and surface erosive ulceration are at high risk of canceration.It is suggested to take treatment measures as soon as possible,and adjust the frequency of review according to pathological results. |
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