Study On The Influencing Factors Of Different Pathology And Canceration Of Large Intestine Polyp

Objective(s): The purpose of this study was to compare the characteristics of different pathological types of colorectal polyps and adenoma-adenocarcinoma series at different stages and the influencing factors of colorectal polyps cancerization,so as to provide certain basis and guidance for endoscopists to rapidly screen high-risk polyps,clinical diagnosis,treatment and follow-up work.Methods: A total of 4700 patients diagnosed with intestinal polyps during hospitalization in the Department of Gastroenterology,The First Affiliated Hospital of Kunming Medical University from January 2020 to December 2022 were retrospectively selected.The diagnosis of intestinal polyps was based on electronic colonoscopy,and the diagnosis of intestinal cancer was based on histopathological examination.Clinical data of patients were collected,including gender,age,height,weight,smoking history,drinking history,diabetes history,hypertension history,family history of bowel cancer,personal history of bowel cancer,as well as the position,shape,size,quantity and pathological type of polyps.The influencing factors of different pathological types of intestinal polyps and the influencing factors of carcinogenesis of large intestine polyps were analyzed.SPSS 26.0 statistical software was used for statistical analysis of the data.P<0.05 was considered statistically significant.Results:1.Analysis of influencing factors of intestinal polyp carcinogenesis:A total of 4700 patients were investigated for the influencing factors of colorectal polyp canceration,among which 665 patients developed canceration,with a canceration rate of 14.1%.There was no significant difference in the rate of intestinal polyp canceration among patients with different gender,different BMI groups,diabetes mellitus,alcohol consumption or family history of bowel cancer(P >0.05).There were significant differences in intestinal polyp canceration rate among patients with different age groups,hypertension,smoking,history of bowel cancer,different polyp sites,different polyp morphology,different polyp surface conditions,different number of polyps(single or multiple),and different polyp diameters(P <0.05).The results of unconditioned binary Logistic regression analysis showed that age,hypertension,smoking,polyp site,polyp morphology,polyp surface,pathological types and polyp size were the factors affecting the carcinogenesis of intestinal polyps(P<0.05).2.The influencing factors of different pathological types of intestinal polyps:Factors influencing the presentation of different pathological types of intestinal polyps: A total of 4700 patients were investigated,including 5 villous adenomas,Too few cases were not included in the analysis;69 cases were found to be "adenocarcinoma",and the pathologic type before canceration could not be found,so they were not included in the analysis.Finally,4626 cases were included in the analysis.Among the 4626 patients,there were 726(15.7%)non-neoplastic polyps,2905(62.8%)tubular adenomas,and 995(21.5%)tubular villous adenomas.Univariate analysis showed that gender,BMI,diabetes mellitus,smoking,alcohol consumption and family history of bowel cancer were not factors affecting different pathological types of intestinal polyps(P >0.05).Age,hypertension,history of bowel cancer,different polyp sites,different polyp morphology,different polyp surface conditions,different polyp number(single or multiple)and different polyp size(mm)were the factors affecting different pathological types of intestinal polyps(P <0.05).The results of multivariate analysis showed that polyp size,age,polyp site,polyp morphology,polyp surface condition and polyp number were the influencing factors of different pathological types of intestinal polyps(P<0.05).The cancer rate of different pathological types was statistically significant(P<0.05).Further pair-based comparison showed that there were differences between the two groups(P<0.001):the cancer rate of tubular villous adenoma group was the highest(42.0%),followed by tubular adenoma group(6.1%),and the lowest non-neoplastic polyps(0).Conclusion(s):1.Polyps of the large intestine tend to occur in people aged 45-59,with a male to female ratio of about 1.3:1,and the ratio of polyps distributed in the left colon and the right colon is similar.2.The risk of colorectal polyp canceration is positively correlated with age,and the risk of polyp canceration increases with age,especially over 60 years old.The relationship between smoking and polyp cancer needs further study.The endoscopic features of cancerous polyps include: the polyp was in the rectum,surface lobed,typeⅢ of polyp field classification,single polyps with large diameter.3.Tubular adenoma is the most common pathological type of large intestine polyps,and the risk of cancer increases with the increase of villi in polyps.The pathological types of large intestine polyps are related to the size,location,morphology,surface condition and number of polyps and the age of patients.