| Research purposeBy studying the case characteristics of patients with colorectal polyps,we explored whether cholecystectomy and the occurrence of colorectal polyps are related.Further analysis of blood routine related parameters and blood lipid levels in patients with adenoma colonic polyps.To provide a theoretical basis for the early detection of adenomatous polyps and endoscopic treatment in patients with a history of cholecystectomy,triglycerides,and NLR abnormalities.MethodsA total of 349 patients who underwent colonoscopy after the outpatient and inpatient department of the Department of Gastroenterology of the First Affiliated Hospital of Chengdu Medical College from January 2018 to January 2019 were collected.Collect general clinical data and laboratory data of patients,including patient’s gender,age,abdominal color Doppler ultrasound(with or without cholecystectomy),white blood cell count,neutrophil count,lymphocyte count,platelet count,total bile acid,total cholesterol,glycerol Triester,high-density lipoprotein cholesterol,low-density lipoprotein cholesterol,colorectal report of patients with colon polyps(recording polyp size,number,location,morphology),pathological biopsy report of polyps(adenomatous polyps,hyperplastic polyps,Inflammatory polyps).The ratio of neutrophils to lymphocytes and the ratio of platelets to lymphocytes were calculated according to blood indicators.(1)The 349 patients included were divided into the cholecystectomy group and the non-cholecystectomy control group according to their previous cholecystectomy,and the incidence of colorectal polyps was compared between the two groups;(2)115 patients with colorectal polyps According to the presence or absence of cholecystectomy,it was divided into the group of cholecystectomy polyps and the group of no cholecystectomy polyps,and the correlation analysis was performed on the type,size,number,location and shape of the two groups of polyps;(3)To further explore the occurrence of adenomatous polyps related factors were divided into adenomatous polyp group and non-colon polyp control group according to the pathological type of polyps,and statistically significant indicators were included in the logistic regression model after univariate analysis.Influence of inflammatory indexes on adenomatous polyps;(4)Evaluate the value of triglyceride and NLR alone and in combination for the diagnosis of adenomatous polyps.Results1.A total of 349 eligible subjects were included in this study,aged 30-81 years,with an average age of 56.11±11.13 years,including 181 males(51.9%)and 168 females(48.1%).The 349 study subjects were divided into the cholecystectomy group(N=75)and the non-cholecystectomy group(N=274)according to the previous cholecystectomy.The chi-square test was used to compare the incidence of intestinal polyps in the two groups.The proportion was 29.2%,and the proportion of intestinal polyps in patients with cholecystectomy was 46.67%,x~2=8.134,P=0.004.The difference was statistically significant,suggesting that the proportion of intestinal polyps in patients with cholecystectomy was higher.2.115 cases of intestinal polyps were further divided into cholecystectomy polyps group(N=35)and non-cholecystectomy polyps group(N=80)according to the presence or absence of cholecystectomy.Chi-square test was used to compare the type and location of intestinal polyps.,Quantity,size,morphological differences.It was found that adenomas accounted for 85.7%of patients with cholecystectomy and 14.3%of other types of polyps(proliferative and inflammatory),x~2=4.102,P=0.043,the difference was statistically significant.The incidence of adenomatous polyps in the cholecystectomy group was higher,but the position,number,size,and morphology of polyps were not statistically significant(P>0.05).3.To further analyze the related risk factors of adenomatous polyps,they were divided into adenomatous polyp group(N=84)and intestinal polyp control group(N=234)according to the presence or absence of adenomatous polyps.Logistic regression analysis showed that there was a statistically significant correlation between age,gender,gallbladder resection,and colorectal adenoma in clinical data(P<0.05).Among patients with adenoma polyp,the detection rate was higher than that in men.Female(75%vs.25%,P<0.001),male is a risk factor for adenomatous polyps(OR=5.121,95%CI:2.557~10.258,P<0.001);with age,adenomatic The incidence of polyps increased significantly(OR=1.760,95%CI:1.331~2.327,P<0.001);the risk of adenomas in patients with previous cholecystectomy increased(OR=2.215,95%CI:1.081~4.540,P<0.03).Among the test indicators,there were no significant differences in platelet to lymphocyte ratio(PLR),platelets,leukocytes,total blood bile acid levels,total cholesterol,HDL cholesterol,and LDL cholesterol(P>0.05).The differences in neutrophil-lymphocyte ratio(NLR)and triglycerides were statistically significant.%CI:1.853~3.558,P<0.001),indicating that NLR and triglycerides are risk factors for adenomatous polyps.4.To further analyze the diagnostic value of adenomatous polyps.ROC curve analysis was performed,and the results showed that triglyceride and NLR had certain diagnostic value for adenomatous polyps.When the NLR cutoff value is 1.775,the NLR sensitivity is 63.1%,and the NLR specificity is 67.5%;when the triglyceride cutoff value is1.485mmoL/L,the triglyceride sensitivity is 61.9%,and the specificity is 81.6%.It was 63.1%and the specificity was 82.9%.The area under the ROC curve of NLR is66.3%,the area under the ROC curve of triglycerides is 68.7%,and the area under the ROC curve when the two are combined is 75.5%.Conclusions:1.Incidence of colorectal polyps increased in cholecystectomy,and incidence of adenomatous polyps increased.2.High levels of triglycerides and NLR are closely related to the occurrence of adenomatous polyps.3.Triglycerides and NLR can be used as auxiliary diagnostic indicators for adenomatous polyps. |
PDF Full Text Request