Analysis Of Related Risk Factors And Pathological Characteristics Of Single-center With Simultaneous Gastric And Colonic Polyps

Objective:To understand the polyp detection rate and the trend of pathological characteristics in the population under gastrointestinal endoscopy,to further explore the clinical characteristics and related risk factors of gastric polyps and colorectal polyps in the population,and to study the static cross-sectional characteristics of polyps of different pathological types(such as The size,shape and location of the lesions),to provide clinical evidence for future screening programs for gastrointestinal polyps.Methods:(1)In 2014,2017,2019,there were 14092 patients who underwent gastroscopy and/or colonoscopy in the outpatient department of the Gastroenterology Department of the First Hospital of Jilin University(Second Department)and the inpatient ward of the Department of Gastroenterology in 2019,Compare the change trend of polyp detection rate and pathological type of patients undergoing gastrointestinal endoscopy in the past 5 years.(2)A total of 238 patients underwent gastroscopy and colonoscopy at the same time,using a case-control study method,the patients with gastric polyps and colorectal polyps as the case group(n=76 cases),and the patients with simple gastric polyps as the control group 1(N=84 cases),the patients with simple colorectal polyps were used as the control group 2(n=78 cases),and the binary logistic regression analysis was used to perform single factor analysis on the risk factors,and the relevant risk factors were again subjected to binary logistic regression Analyze and screen out the final independent risk factors.The chi-square test was used to compare the general conditions between the groups,and to compare the size,location and pathological type of polyps between the groups.P<0.05 indicates statistical significance.Result:(1)In 2014,3022 patients underwent gastroscopy,79 cases(2.61%)of gastric polypoid lesions were detected under endoscopy,968 cases of colonoscopy patients,175 cases(18.08%)of colorectal polypoid lesions were detected under endoscopy In2019,7125 patients underwent gastroscopy,299 cases(4.20%)of gastric polypoid lesions were detected under endoscopy,1472 cases of colonoscopy patients,and 362cases(24.59%)of colorectal polypoid lesions were detected under endoscopy.Pathological types of gastric polyps in 2014(56 cases): 34 cases(60.71%),20 cases(35.72%),and 2 cases(3.57%)of hyperplastic polyps,fundus gland polyps,and gastric adenomas,respectively.Pathological types of gastric polyps in 2019(242cases): 114 cases(47.11%),119 cases(49.17%),and 9 cases(3.72%)of hyperplastic polyps,fundus gland polyps,and gastric adenomas,respectively.Pathological types of colorectal polyps in 2014(148 cases): 137 cases(92.56%)of common adenoma,23cases(15.54%)of benign serrated lesions,17 cases(73.91%)of hyperplastic polyps,SSA/P There were 6 cases(26.09%)and 0 cases of TSA.Pathological types of colorectal polyps in 2019(338 cases): 318 cases(94.08%)of ordinary adenomas,46cases(13.61%)of benign serrated lesions,32 cases(69.57%)of hyperplastic polyps,SSA/P There were 13 cases(28.26%)and 1 case(2.17%)with TSA.(2)According to the results of single factor analysis,correlation coefficient and actual clinical significance,the risk factors of age(>60 years old),smoking history,drinking history,fatty liver disease history,hyperlipidemia,HP infection,and CA199 elevation were screened.The results of the multivariate binary logistic regression analysis of the above-selected variables showed that none of the above factors were independent risk factors for gastric polyps and colorectal polyps(P were 0.355,0.517,0.579,1.000,0.724,1.000,0.192).(3)There was no significant difference in the location,number,size and pathological type of polyps between the case group and the control group 1 and the control group 2(P>0.05).Conclusion:(1)In the past five years,the detection rate of gastrointestinal polyps has increased year by year.The detection rate of gastric polyps increased from 2.61% in2014 to 4.20% in 2019,and the detection rate of colorectal polyps increased from18.08% in 2014 to 24.59% in 2019.(2)The detection rate of gastric proliferative polyps is decreasing year by year(from 60.71% in 2014 to 47.11% in 2019),while the detection rate of gastric gland polyps is increasing year by year(from 35.72% in 2014)To 49.17% in 2019).(3)Colorectal common adenoma is the most common pathological type of colorectal polyps,accounting for about 90.00% of colorectal polyps.(4)There is a significant overlap between the detection rates of serrated lesions and common adenomas.Approximately 50.00% of hyperplastic polyps and SSA/P patients also have synchronous common adenomas.(5)The characteristics of gastric polyps and simple gastric polyps in the group of gastric polyps combined with colorectal polyps are similar.They are mainly single gastric polyps.The diameter of polyps is often less than 5mm,and they are more common in the stomach and fundus.Among them,the fundus gland polyps are the most common.Common pathological types.(6)The characteristics of colorectal polyps in the gastric polyp combined with colorectal polyps group are similar to those of simple colorectal polyps.Multiple colorectal polyps are the main ones.The diameter of polyps is usually between 5 and10 mm.It is more common in the left colon.Tumor is the most common pathological type.(7)When gastric polyps and colorectal polyps occur,the age is more than 60 years,there is a history of smoking,drinking,and HP infection,colorectal polyps are mostly multiple colorectal polyps.In addition,in patients with HP-infected polyps,the diameter of polyps is mostly 5-10 mm.Among polyps patients with elevated CA199,most are common adenomas.When gastric polyps and colorectal polyps occur,it is recommended to eradicate Helicobacter pylori.