The Risk Factors Of Cancer For Granular Colorectal Laterally Spreading Tumor

Aim:To study the clinicopathological characteristics of granular colorectal laterally spreading tumor(LST-G),analyze the risk factors of cancer for LST-G,and to provide guidance for the diagnosis and treatment of clinical diagnosis and treatment.Methods:We retrospectively studied the patients'materials who were fond and treated in our hospital between October 2013 and November 2016.After excluding some cases according to the exclusion criteria.Ultimately,a total of 65 colorectal LST-G treated with endoscopic submucosal dissection(ESD)or endoscopic mucosal resection(EMR)were enrolled in our study.General clinical data include age,gender,the family history of colorectal cancer,smoking history and drinking history;Specific features of the lesion include diameter size,nodule size(largest nodule or main nodule)and location.Firstly,we fond possible risk factors with chi-square test or t test,then we fond independent risk factor with multi-factor analysis of logistic.Results:1.A total of 65 colorectal LST-G were enrolled in the study,33 LST-G(50.8%)were cancer,32 LST-G were noncancerous.2.Among the general clinical data of the patients:there were no statistical difference among age(p=0.595),gender(p=0.089),smoking history(p=0.063)and drink history(p=0.097)of two groups(cancer group and noncancerous group);The canceration rate of who have family history of colorectal cancer(83.3%)was higher than those who do not have(43.4%)(p=0.029).3.Among the specific features of lesions:there were no statistical difference among location(p=0.103);The diameter size of cancer group was obviously larger than noncancerous group(21.3±9.8mm vs 19.8±6.8mm p=0.003),and there were statistical difference of canceration rate between lesion diameter groups(p=0.001);There was statistical difference of canceration rate between nodal diameter groups(p<0.001);4.Multi-factor analysis of logistic shows that the independent risk factors of LST-G were the lesion diameter size(p=0.034),nodal diameter size(p<0.001),and the family history of colorectal cancer(p=0.026).The order of OR is the nodal diameter(29.722)>the family history of colorectal cancer(17.090)>the lesion diameter size(0.034).Conclusions:1.Among the general clinical data of the patients:age,gender,location,smoking history and drinking history were not the risk factors of LST-G for cancer,the family history of colorectal cancer is the risk factor of LST-G for cancer.2.Among the specific features of lesions:the location of the lesion is not the risk factor of LST-G for cancer;the diameter size of lesion,the nodule size of the lesion is the risk factors of LST-G for cancer3.Multi-factor analysis of logistic shows that the nodule size have higher predictive value than the family history of colorectal cancer and the lesion diameter size,it means that the bigger of nodule diameter,the higher canceration rate of LST-G.