| Background: Colorectal carcinoma(CRC)is colorectal cancer.It is a common malignancy in the digestive system.Colonoscopy is the most effective method for screening,preventing,and reducing the incidence and related mortality of colorectal cancer.Adenomatous lesions of the rectum can effectively reduce the incidence of colorectal cancer.How to improve the quality of colonoscopy is more and more important.Adenoma detection rate(ADR)is the most commonly used quantitative index to evaluate the quality of colonoscopy.The related research institute of the impact of preparation quality of Dao on the detection rate of adenoma concluded that there is controversy.Objectives: 1.To investigate the influence of intestinal preparation quality grade on ADR and analyze the related influencing factors of ADR.2.To investigate the relationship between the quality of intestinal preparation and the size of adenoma and the number of polyps detected.Methods: A total of 1107 patients who underwent painless colonoscopy at the endoscopy unit of the First Affiliated Hospital of Dalian Medical University from August 2017 to December 2017 were included.Of these,a total of 153 patients did not meet the inclusion criteria.A total of 954 patients were included.In the group,337 cases of polyps were detected and 719 polyps were detected.Pathologically,there were 188 cases of colorectal adenomas(including tubular adenomas,villous tubular adenomas,and mixed adenomas).A total of 188 adenomas were detected.219 polyps.Chi-square test and Logistic regression were used for univariate and multivariate analysis of gender,age,physician,family history,bowel preparation quality,and ADR relationships;Boston bowel prep score and bowel prep score were used to score Boston bowel preparation.>6 points and ?6 points in two groups.Intestinal preparations were divided into three groups: Boston bowel preparation scores of 8-9 points,7 points,and ?6 points.Three groups were defined as "excellent","good",and "poor".Group: The relationship between bowel preparation quality and ADR was investigated by using the rank sum test;and based on the detection of adenomatous polyp size,the patients were divided into groups with diameter ?1cm(84 cases in total)and <1cm(135 cases in total),and were detected by rank sum test analysis.The relationship between the size of adenomas and the quality of bowel preparations;based on the number of polyps detected in the enrolled patients,one-way analysis of variance was used to analyze the relationship between the quality of bowel preparation and the number of polyps detected.Results: 1.ADR univariate chi-square analysis: ADR was 23.6% and 15.8% in males and females respectively.There was a statistically significant difference between the two groups(P=0.003);ADRs in patients aged ?50 and age <50 were 23.2%,8.7%;ADR was statistically significant between the two groups(P<0.05);ADR in Boston bowel preparation scores> 6 points and ?6 points were 23.8% and 8.8%,respectively.There was a statistically significant difference in ADR between the two groups.(P<0.05);ADRs of operating doctors and juniors in high-grade groups were 20.3% and 18.3%,respectively.There was no statistical difference in ADR between the two groups(P=0.537);there was family history and no family history ADR.They were 23.8% and 24.9%,respectively.There was no statistical difference in ADR between the two groups(P=0.860).2.ADR Multivariate Logistic Regression Analysis: The gender,age,and quality of bowel preparation had statistically significant differences in the detection rate of adenomas.The patient gender(OR: 0.566,95% CI: 0.404-0.793),age(OR: 1.042,95).%CI:1.027~1.058)and intestinal preparation quality(OR: 3.097,95% CI: 1.870~5.120)were independent risk predictors of ADR.3.The effect of intestinal preparation quality grade on the detection rate of adenomas: 3.1 The effect of two groups of intestinal preparation on the detection rate of adenoma Gender,age,family history,and operating physicians did not see differences between groups(P=0.069,P=0.672,P=0.636,P=0.937),and ADR scores of >6 in the Boston bowel preparation group and ?6 in the subgroup were 23.8%.8.8% of Boston Boston bowel preparation scores >6 group ADR was significantly higher than Boston group bowel preparation score ?6 group(P<0.05).3.2 The effect of three groups of bowel preparation quality on the detection rate of adenoma Gender,age,and operation physicians did not see any difference between groups(P=0.130,P=0.677,P=0.385,P=0.854).ADRs in the “prepared” group,“good” group,and “excellent” group of bowel preparations were 8.8%,22.5%,and 25.3%.The ADR for the "low-quality" bowel preparation group was lower than the "good" group(P <0.05)and "excellent" group(P <0.05).There was no significant difference in ADR between the "good" group and the "predominant" bowel preparation group(P = 0.220).4.Relationship between intestinal preparation quality grade and adenoma size The ADR with less than 1cm in diameter was significantly lower in bowel preparative quality "less than" group than in the "good" group(P = 0.012)and superior group(P <0.05);the quality of bowel preparation "good" group diameter < The 1 cm ADR was lower than the "predominant" group of intestinal preparation quality(P = 0.015).5.The relationship between the quality of intestinal preparation and the number of polyps Intestinal preparation quality "excellent" group of 132 cases,a total of 350 polyps were detected,the average number of polyps detected was 2.65 ± 1.981;"good" group of 133 cases,a total of 249 polyps were detected,the average number of polyps detected was 1.87 ± 1.144;in the "Unsatisfactory" group of 72 cases,a total of 115 polyps were detected,and the average number of polyps detected was 1.60 ± 1.263;the "good" group had a higher average polyp detection rate than the "unsatisfactory" group,but P = 0.226,no Statistical differences;The average polyp rate of the “unsatisfactory” and“good” groups was lower than that of the “excellent” group(P1=0.000,P2=0.000).Conclusions: 1.Age,gender,quality of bowel preparation are independent risk predictors of adenoma detection rate.Males,with a higher ADR at the age of 50 or older,and a Boston bowel preparation score of >6,could increase ADR.2.The quality of bowel preparation was positively correlated with ADR;better bowel preparation did not improve ADR,but it could increase ADR of adenomas <1cm in diameter and increase the number of polyps detected. |
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