结直肠腺瘤合并高级别上皮内瘤变的危险因素分析  

Analysis of Risk Factors for Colorectal Adenoma Complicated With High-Grade Intraepithelial Neoplasia

作　　者：黄建敏[1] 陈毓岱 方超英[1] HUANG Jianmin;CHEN Yudai;FANG Chaoying(Digestive Endoscopy Center,Fujian Provincial Hospital South Branch,Fuzhou Fujian 350028,China)

机构地区：[1]福建省立医院南院消化内镜中心,福建福州350028

出　　处：《中国卫生标准管理》2024年第18期96-101,共6页China Health Standard Management

摘　　要：目的探讨结直肠腺瘤(colorectal adenoma,CRA)合并高级别上皮内瘤变(high-grade intraepithelial neoplasia,HGIN)的独立危险因素。方法选取2022年1—12月于福建省立医院南院消化内镜中心接受全结肠镜检查且病理结果明确为CRA的256例住院患者。分析患者的基本信息,包括性别、年龄、身体质量指数(body mass index,BMI)、相关基础疾病病史、息肉部位和形态学信息、息肉术后病理信息等,采用单因素、多因素logistic回归分析CRA合并HGIN发生的危险因素。结果单因素logistic回归分析发现,年龄对CRA合并HGIN的影响差异有统计学意义(OR=1.037,95%CI 1.006~1.069,P=0.019);腺瘤数目对CRA合并HGIN的影响差异有统计学意义(OR=0.188,95%CI 0.065~0.543,P<0.001);腺瘤分叶状、病理组织类型、腺瘤部位、腺瘤形态、黏膜表面情况均对CRA合并HGIN的影响差异有统计学意义(P<0.001)。多因素logistic回归分析发现,高龄、病理组织类型为含绒毛状成分腺瘤、黏膜表面粗糙、糜烂均与CRA合并HGIN发病率高相关(P<0.05)。结论高龄、病理组织类型为含绒毛状成分腺瘤、黏膜表面粗糙、糜烂是CRA合并HGIN的独立危险因素。Objective To explore the independent risk factors of colorectal adenoma(CRA)complicated with high-grade intraepithelial neoplasia(HGIN).Methods A total of 256 inpatients who underwent total colonoscopy at the digestive endoscopy center,Fujian Provincial Hospital South Branch from January to December 2022 and whose pathological results were confirmed to be CRA were selected.Basic information of patients was analyzed,including gender,age,body mass index(BMI),relevant underlying medical history,polyp location and morphology,post-polypectomy pathology information,etc.Univariate and multivariate logistic regression were used to analyze the risk factors of CRA complicated with HGIN.Results Univariate logistic regression analysis revealed that age had a statistically significant impact on the development of CRA complicated with HGIN(OR=1.037,95%CI 1.006-1.069,P=0.019).The effect of the number of adenomas on CRA complicated with HGIN was statistically significant(OR=0.188,95%CI 0.065-0.543,P<0.001).The effects of adenoma morphology,pathological tissue type,adenoma location,adenoma morphology and mucosal surface on CRA complicated with HGIN were statistically significant(P<0.001).Multivariate logistic regression analysis found that advanced age,adenomas with villous components in pathological type,and rough or ulcerated mucosal surface were highly correlated with the incidence of CRA complicated with HGIN(P<0.05).Conclusion Advanced age,adenomas with villous components in pathological type,and rough or ulcerated mucosal surface are independent risk factors for the development of CRA complicated with HGIN.

关 键 词：纤维结肠镜 早期结肠癌 结肠腺瘤 多因素 回归分析 病理特征 

分 类 号：R735[医药卫生—肿瘤]