| OBJECTIVE:1.To analyze the correlation factors of postoperative colonic polyps such as morphology type,colorectal location and age of patients.2.To compare the value of fecal occult blood test(immunocolloidal gold method,digitalimmunoassay poop-poop tube test)and digital immunoassay combined with fecal DNA test(FIT-DNA)for detecting fecal occult blood in screening of colorectal related diseases.METHOD:1.From January 2016 to August 2019,a total of 572 patients received colon polypectomy in the department of gastroenterology and out-patient department of chaohu hospital affiliated to 'an medical university were retrospectively analyzed.Demographic data,polyp type,anatomic site and pathological classification of patients were collected.300 patients were randomly selected by questionnaire survey to obtain complete data of subjects.SPSS 26.0 was used for chi-square statistical analysis of the relationship between postoperative pathological type of colon polyps and patients' age,gender,polyp location and size,as well as their life and diet habits.2.A total of 244 patients who underwent colonoscopy in the Department of Gastroenterology,Gastrointestinal Surgery,and Outpatient Clinic from May,2018 to November,2018 from the first affiliated hospital of Anhui medical university,the second affiliated hospital of Anhui medical university,and the affiliated Chaohu hospital of Anhui medical university were enrolled.The fecal occult blood test wasconducted by using the above four tests.To compare 4 detection methods in diagnosis of colorectal cancer,identification of colon lesions,diagnosis of colorectal cancer precancerous lesions,diagnosis of high-risk adenomas and diagnosis predictive efficacy in tumor staging.RESULTS:1.The detection rates of high-risk adenoma and low-risk adenoma in patients were significantly different in different parts of the colorectal(P < 0.05).There was no significant difference between high-risk adenoma and low-risk adenoma and gender(P>0.05),but the incidence of male adenoma was higher than female adenoma.There were significant differences between the size of adenoma and the pathological type of adenoma,and the heterogeneity of adenoma was correlated with the pathological type of adenoma(P<0.05).Among the 300 randomly selected patients,156 high-risk adenomas and 144 non-high-risk adenomas had statistically significant differences with age,body mass index(BMI),diet,smoking and family history(P < 0.05).There was no significant difference between the prevalence and alcohol consumption(P>0.05).2.The sensitivity and negative predictive value of FIT-DNA detection in the identification of colorectal cancer and the positive rate of colorectal cancer and high-risk adenomatous diseases were higher than the other three;The rate of false positive to other(inflammatory and non-specific enteritis)and normal large intestine was lower.All the differences were statistically significant(P < 0.05).FIT-DNA detection has higher sensitivity,negative predictive value and positive likelihood ratio in the diagnosis of precancerous lesions,high-risk adenomas and colorectal cancer than the other three.All the differences were statistically significant(P < 0.05).The results of area under ROC curve showed that the diagnostic efficacy of fit-dna,FIT,puff-tube screening method and immunocolloidal gold method showed statistically significant differences(P < 0.000).For patients undergoing surgical treatment,there was a significant positive correlation between the numerical value and disease stage.But inFIT-DNA,there was no correlation.CONCLUSION:1.There was a significant correlation between the pathological type of colon polyps after operation and the patient's age,location and size of polyps,and there was a significant difference with People's Daily diet and living habits.2.FIT-DNA detection was significantly more sensitive and positive than the other three detection methods in differentiating colorectal cancer,precancerous lesions and high-risk adenoma.The false positive rate was lower in normal large intestine and other lesions.The area under the subject working characteristic curve showed that FIT-DNA detection was the most effective method to predict the prelesions of colorectal cancer.FIT is positively correlated with colorectal cancer tumor staging. |
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