Clinicopathologic Analysis Of Serum Homocysteine,Folic Acid,Uric Acid,Blood Lipid And Colorectal Polyp Patients And Their Diagnostic Value

Objective: To analyze the serum Homocysteine(Hcy),Folic acid(FA),Uric acid(UA)and blood lipid levels in patients with different pathological types of colorectal polyps and healthy people,so as to provide reference for early clinical intervention.According to the statistical results,the receiver operating characteristic(ROC)curve was drawn for the indicators with statistically significant differences(P < 0.05)and the area under the curve(AUC)was compared.To explore its diagnostic value for colorectal polyps and guide clinical diagnosis and treatment.Methods:(1)A total of 250 patients with colorectal polyps diagnosed by electronic colonoscopy and pathological examination in the Department of Gastroenterology,the Affiliated Hospital of Youjiang Medical College for Nationalities from September 2021 to December 2022 were collected.According to different pathological types,they were divided into colorectal adenomatous polyp group(CAP group)and colorectal non-adenomatous polyp group(NCAP group).Villous tubular adenoma in 10 cases),including 80 males and 70 females.There were 100 cases in NCAP group(89 cases of inflammatory polyps,3 cases of juvenile polyps and 8 cases of hyperplastic polyps),including 53 males and 47 females.At the same time,50 healthy people with normal mucosa detected by electronic colonoscopy were collected as the healthy control group,including 20 males and 30 females.(2)The general data of the selected cases were collected,including gender,age,height,weight,and ethnicity,and the body mass index(BMI)was calculated.Laboratory tests: UA,blood lipid: The levels of total cholesterol(TC),triglyceride(TG),high density lipoprotein(HDL),low density lipoprotein(LDL),apolipoprotein A1(Apo A1),apolipoprotein B(Apo B),lipoprotein a [LP(a)],and serum Hcy and FA were measured.(3)The general clinical data,serum Hcy,FA,UA,TC,TG,HDL,LDL,Apo A1,Apo B and LP(a)levels were analyzed and compared between CAP group,NCAP group and healthy control group.According to the statistical results,ROC curves were drawn for indicators with statistically significant differences(P < 0.05)and AUC was compared to explore its diagnostic value for colorectal polyps.(4)After grouping colorectal polyps according to different location,number and size,the serum levels of Hcy,FA,UA,TC,TG,HDL,LDL,Apo A1,Apo B and LP(a)were compared between the groups.SPSS 25.0 software was used for statistical analysis,and P < 0.05 was considered statistically significant.Results:(1)There was no significant difference in gender,age,ethnicity and BMI among CAP group,NCAP group and healthy control group(P > 0.05).(2)The serum levels of Hcy,UA,TC,LDL and Apo B in patients with colorectal polyps were higher than those in healthy control group,while the serum levels of FA were lower than those in healthy control group.The levels of Hcy,FA,UA,TC,LDL and Apo B in CAP group,NCAP group and healthy control group were compared(P < 0.05),and the differences were statistically significant.The levels of Hcy,FA,UA,TC,LDL and Apo B between CAP group and healthy control group were compared(P < 0.05),and the differences were statistically significant.The levels of Hcy,FA,UA,TC,LDL and Apo B between the NCAP group and the healthy control group were compared(P < 0.05),and the differences were statistically significant.The levels of Hcy,FA,UA,TC,LDL and Apo B between CAP group and NCAP group were compared(P< 0.05),and there was no statistical significance.(3)There was no significant difference in the levels of TG,HDL,Apo A1 and LP(a)between CAP group and NCAP group(P > 0.05).(4)The AUCs of Hcy,FA,UA,TC,LDL and Apo B in the diagnosis of colorectal polyps were0.682,0.615,0.657,0.624,0.637 and 0.624,respectively.The sensitivity of Hcy,FA,UA,TC,LDL and Apo B in the diagnosis of colorectal polyps were 81.2%,64.8%,96.4%,59.6%,84%and 48.8%,respectively.The specificity of Hcy,FA,UA,TC,LDL and Apo B in the diagnosis of colorectal polyps was 50%,64%,28%,62%,40% and 72%,respectively.The optimal cut-off values of Hcy,FA,UA,TC,LDL and Apo B in the diagnosis of colorectal polyps were31.2%,28.8%,24.4%,21.6%,24% and 20.4%,respectively.The AUC of Hcy combined with UA in the diagnosis of colorectal polyps was 0.656,the sensitivity was 93.2%,the specificity was 32%,and the best cut-off value was 25.2%.The AUC values of Hcy,UA and Hcy combined with UA in the diagnosis of colorectal polyps were compared between each two groups(P > 0.05),and the difference was not statistically significant.(5)There were no significant differences in the levels of serum Hcy,FA,UA,TC,TG,HDL,LDL,Apo A1,Apo B and LP(a)between single colorectal polyp group and multiple colorectal polyps group,large colorectal polyp group and small colorectal polyp group(P > 0.05).There were no significant differences in the levels of serum Hcy,FA,UA,TC,TG,HDL,LDL,Apo A1,Apo B and LP(a)among the ascending colon polyps group,transverse colon polyps group,descending colon polyps group,sigmoid colon polyps group and rectal polyps group(P >0.05).Conclusion:(1)The levels of serum Hcy,UA,TC,LDL and Apo B in patients with colorectal polyps were higher than those in the healthy control group,and the level of FA was lower than that in the healthy control group.(2)The levels of serum Hcy,FA,UA,TC,LDL and Apo B may be correlated with the occurrence of colorectal polyps.(3)The detection of serum Hcy,FA,UA,TC,LDL and Apo B levels has certain reference value for the diagnosis of patients with colorectal polyps.