Analysis Of Risk Factors For Pathological Differences Between Colorectal Adenomatous Polyps And Postoperative Resection

Objective: This study compares the pathology of colorectal adenomatous polyps(lowgrade intraepithelial neoplasia)with endoscopic biopsy forceps biopsy and endoscopic resection to explore the pathological features of colorectal polyp endoscopic resection.The risk factors of pathological escalation in forceps biopsy and the establishment of a pathological escalation prediction model provide some reference information for actual clinical work.Methods: A total of 410 patients with pathologically diagnosed low-grade intraepithelial neoplasia were screened from the Department of Gastroenterology,People's Hospital of Xinjiang Uygur Autonomous Region.They found polyps and took EFB during colonoscopy from January 2017 to June 2019.The polyps were then removed by ESD or EMR in our hospital.The two pathological results were compared and the patients were divided into the pathologically indifferent group and the pathologically upgraded group.Univariate analysis was used to compare the age,sex,body mass index,history of abdominal surgery,operating doctor title,number of days between examinations,and endoscopic characteristics.The differences were screened for statistically significant indicators and multi-factor logistic regression analysis was performed to establish a pathological upgrade prediction model.Results: The overall difference between polyps biopsy pathology and postoperative pathology was 23.7%.Univariate analysis showed that polyp color,polyp position,polyp diameter,number of biopsy blocks,whether polyps were smooth,and whether polyps were eroded or bleeding.The difference in distribution was statistically significant(P <0.05),the color of the polyp was red,the position of the polyp was in the cecum,descending colon,sigmoid colon,and rectum,the diameter of the lesion was ?10 mm,the number of biopsy blocks was greater than 1,the polyps were not smooth,and the polyps were eroded or bleeding.A large proportion of patients experienced pathological escalation.Multivariate logistic regression analysis showed that the color of the polyp(whitening: OR = 6.949,redness: OR = 4.095),the position of the polyp(rectum: OR = 3.701),the diameter of the polyp(?10mm: OR = 4.462),polyp erosion or bleeding(erosion or bleeding: OR = 10.918)is related to the pathological escalation of polyps,the color of the polyps is white and red,the position of the polyp is rectum,the lesion is ?10mm,erosion or bleeding of polyps are risk factors for pathological escalation of the lesion.The area under the ROC curve of the established pathological upgrade model was 0.823(0.771 ~ 0.875),the sensitivity was 82.9%,and the specificity was 68.0%.The model prediction effect was good.Conclusion: The surface color of adenomatous polyps is white,red,eroded or bleeding,the diameter is ?10mm,and it is located in the rectum and is related to the development of biopsy biopsy and postoperative pathological upgrade.They are all risk factors for the pathological upgrade of polyps.The pathological upgrade risk prediction model has Certain clinical application value.