| Objective: To investigate the clinical and endoscopic characteristics of sentinel polyps,and analyze the expression of cancer stem cells markers(CD44,CD166 and CD133)in normal tissues,colon inflammatory polyps,sentinel polyps and colon cancer,in order to provide a theoretical basis for the early screening of proximal colon cancer.Methods:1.Retrospective analysis of clinical and endoscopic characteristics of sentinel polyps :(1)Clinical data of patients with rectal polyp from January 2015 to December 2020 in a hospital were retrospectively analyzed,and medical records of patients with proximal colon cancer were screened out.Thus,the endoscopic characteristics were statistically analyzed by grouping(sentinel polyps group /rectal polyps group);(2)The hospitalized patients medical records information were collected,and setting up rectal polyps group and proximal colon cancer group as control groups,compared and analysised the differences between groups.2.Immunohistochemical method was used to detect the expression of CD44,CD166 and CD133 in 16 groups of normal colorectal tissue(normal group),inflammatory polyp of colon(inflammatory group),sentinel polyps(sentinel group)and adenocarcinoma of colon(cancer group).And statistical software was used to analyze the relationship between them.Results:1.(1)A total of 103 sentinel polyps and 103 rectal polyps were included in our study.Compared with rectal polyps,there were statistically significant differences between the two groups in number of polyps(P<0.001),polyp morphology(P=0.003),Yamada types(P<0.001),and pathological types(P=0.001).(2)55 patients with sentinel polyps,rectal polyps,and proximal colon cancer were enrolled.Compared with rectal polyps,the difference between the two groups was statistically significant in age(P<0.001),weight(P<0.001),hypertension(P=0.013),abdominal pain(P=0.002),feces(P<0.001),other symptoms(such as nausea,vomiting,emaciation,fatigue,dizziness,palpitations)(P=0.027),abdominal tenderness(P=0.003),red blood cells(P<0.001),hemoglobin(P<0.001),liver function(P<0.001),kidney function(P=0.010),electrolyte(P=0.008),fecal occult blood test(P<0.001),CEA(P<0.001).Compared with proximal colon cancer,the difference between the two groups was statistically significant in age(P<0.001),other symptoms(nausea,vomiting,emaciation,fatigue,dizziness,palpitations)(P=0.010),red blood cells(P=0.001),hemoglobin(P=0.006),electrolytes(P<0.001),and intestinal obstruction(P=0.010).(3)According to univariate logistic regression analysis,age and hypertension(P<0.05)maight be risk factors for sentinel polyps,and after further multivariate logistic regression analysis,age(P<0.001)was more likely to be an independent risk factor for sentinel polyps.2.The results of immunohistochemistry: CD44 was mainly expressed in the cell membrane of the colon gland,CD166 and CD133 were mainly expressed in the cell membrane and cytoplasm of the colon gland,and the positive reaction was yellow or brown-yellow.(1)Compared with the normal group and inflammatory group,the expression of CD44 was increased in the sentinel group(P<0.0001).(2)Compared with normal group,the expression of CD166 in sentinel group was increased(P<0.050).(3)Compared with the normal group,the expression of CD133 was increased in the sentinel group(P<0.010);compared with cancer group,the expression of CD133 was decreased in sentinel group(P<0.001).Conclusion:1.Sentinel polyps are mainly characterized by multiple,lobulated,pedicled polyps under endoscopy,and classified as Yamada type III and type IV polyps.Clinical features are often complicated with weight loss,abdominal pain,anemia and other atypical symptoms,and abnormal results of blood routine,liver function,kidney function,electrolytes and CEA are common in laboratory tests.2.Age is an independent risk factor for sentinel polyps.3.The expression levels of CD44,CD166 and CD133 in the sentinel group and the cancer group are higher than those in the normal and the inflammatory group,and the pathological type of adenomatous polyps in the sentinel group are higher than that in the rectal polyp group,indicating that sentinel polyps may be more prone to canceration and should be treated in time in clinical practice. |
