Clinic Retrospective Studybetween Pathological Classification Of Colorectal Polyps And Lipid Metabolic Correlation Factors

ObjectiveAs one of the most common diseases of colon,colonic polyps are lesions that arise from the lining of the colon and arise on the surface of the mucosa,it is usually overgrowth from epithelial and extends from the mucosal surface to the lumen.Its pathological types are divided into adenomatous polyp that contain tubular adenoma,mixed adenoma,villous adenoma,serrated adenoma,and non-adenomatous polyp that include hyperplastic polyps,inflammatory polyps,juvenile polyps.^[1]Adenomatous polyps have been recognized as precancerous lesions of colon cancer Morson considered there are 50%-70%of colon cancer comes from adenomatous polyps and canceration rate of adenomatous polyp are 2.9%-9.4%.^[2]And the canceration went through four stages of evolution:hyperplastic adenoma to tubular adenoma to villous adenoma to early carcinoma and to invasive carcinoma.^[3]So the Prevention of colonic polyps can reduce the incidence of carcinoma of colon.The metabolic syndrome?MS?is a risk factor for coloreetal cancer?CRC?has been found by a great quantity of studies,which is closely related with progress and prognosis of CRC.^[4]At the same time,numbers of literatures have reported that MS are also associated with colonic polyps.^[5-8]With the thorough study on mechanism of MS,the function of adipose tissue is more detailed.Adipose tissue plays an important role in regulating lipid and energy balance,and it relate to the whole body,could integrated systemic lipid balance by controlling the level of non-esterified fatty acid,synthesizing and releasing adipocyte factor?such as leptin,adiponectin resistin and so on?.^[9]When regulation of adipose tissue function disorders,especially the separation of release ability of non-esterified fatty acid and energy requirement of non-adipose tissue was disturbed,it would lead to elevated levels of non-esterified fatty acids in plasma,excessive storage of triacylglycerol,and the damage to the normal tissue.^[10]Adipose tissue is considered to be the major source of non-esterified fatty acid that can promote macrophage infiltrate and excrete various inflammatory chemokine,cytokines and adipocytokines,related to insulin resistance,and can further promote the occurrence of inflammation.^[11]The metabolism of adipose tissue is mediated by tumor-necrosis-factor-?in the early stage of non-icoholic hepatocirrhosis,and interleukin-6 and tumor-necrosis-factor-?increased expression of suppressors of cytokine signaling in the liver.^[12]Multiple studies have shown that chronic inflammation is involved in the early formation of colorectal cancer,^[13-14]However,there are few studies on the relationship between serum levels of fat and inflammatory markers in the serum level and adipose tissue of patients with colon polypsThe incidence of colonic polyp is increasing as the change of diet structure nowadays.Sanya is located in the southernmost of China,it is separated from the mainland China,and has a special geographical background and eating habits,residents catering mainly to seafood,high calorie and purine diet.^[15]The research results have shown that it is may be one of the causes of lipid metabolism?obesity,disorders of glucose metabolism,hypertension,hyperuricemia,etc.?diseases to reduce the intake of staple food,increase oil,meat,fish,shrimp,shellfish intake.^[16]Xiaokun Zhang and his colleges found that people in coastal areas are more likely to cause lipid metabolism disorders due to eating habits?high purine diet?.^[17]Therefore,it could provided direction to CRC to study the relationships between colonic polyps and lipid metabolism,and it also has clinical significance to carry out epidemiological studies on biochemical indexes and clinical research of patients with colon polyps.Up till now,large numbers of study are still focuses on the correlation between colonic polyps and blood lipids,consequently,this study carries 407 cases with colon polyps in recent 7 years in our hospital?Third People's Hospital of Hainan Province?Province)on the review analysis to study the difference of biochemical indexes in differentpathologicaltypesofcolonpolyps,which can provide evidence for medical researches in study on the relationship between micro inflammatory factors factors and occurrence and development of colonic polyps,its aim to prevent the occurrence of colonic polyps and reduced morbidity of CRC.MethodsThere were 407?including 17 cases of canceration of polyp?patients with colonic polyps met the requirements of the survey enrolled in this study from January 2015 to January 2017 in Department of Gastroenterology in the Third people's Hospital of Hainan province.The morning fasting venous blood of all subjects were obtained to detect the level of serum lipid?including triglyceride,total cholesterol,low density lipoprotein and high-density lipoprotein?,blood fat comprehensive index[including myosin,alkaline phosphatase,non high density lipoprotein cholesterol,TC/?HDL+TBIL?and LDL/?HDL+TBIL?],serum bilirubin?including total bilirubin,direct bilirubin and indirect bilirubin?,micro inflammatory markers?including interleukin 6,tumor necrosis factor alpha,C reactive protein,serum albumin,white blood cell count and hematocrit?.At the same time,colonoscopy was used to detect the number,location and shape of polyps,and to observe the characteristics of keaty,to determine it solitary or not.Chi square test was used to analyze the differences of colon polyps in different basic cases,F test method was used to analyze the differences of blood lipid and biochemical in patients with different types of colonic polyps,Logistic regression analysis was used to research the specific effects of various blood lipid indicators on pathological types of polyps?including canceration of polyps?.Results1.There were significant differences in the incidence of colonic polyps in different ages?X²=126.25,P=0.00?,occupation?X²=87.07,P=0.00?,marital status?X²=260.85,P=0.00?,dietary habits?X²=164.57,P=0.00?,exercise habits?X²=469.19,P=0.00?,smoking habits?X²=469.19,P=0.00?,drinking habits?X²=249.96,P=0.00?and BMI value?X²=172.68,P=0.00?.2.The difference of colonic polyps was statistically significant in different locations of colonic polyps?X²=353.34,P=0.00?,pathological type?X²=618.31,P=0.00?,the growth pattern of colonic polyps?X²=275.31,P=0.00?,the form of colonic polyps?X²=86.29,P=0.00?.3.There were significant differences in pathological typing in different gender?X²=10.05,P=0.02?,ages?X²=96.43,P=0.00?,marital status?X²=267.75,P=0.00?,diet habit?X²=53.49,P=0.00?,exercise habit?X²=104.05,P=0.00?,smoking habit?X²=43.60,P=0.00?,drinking habit?X²=19.22,P=0.00?,BMI value?X²=83.57,P=0.00?,colon polyp location?X²=75.30,P=0.00?,growth mode of colon polyp?X²=51.02,P=0.00?and the form of colon polyp?X²=40.20,P=0.00?.4.Significant differences were found in different pathological types of colonic polyps in the level of TG?F=640.40,P=0.00?,TC?F=516.70,P=0.00?,LDL?F=276.40,P=0.00?,LDL?F=368.83,P=0.00?,LCI?F=785.36,P=0.00?,AIP?F=1045.78,P=0.00?, Non-HDL?F=799.99,P=0.00?,TC/?HDL+TBIL??F=1069.66,P=0.00?, LDL/?HDL+TBIL??F=2334.36,P=0.00?,TBIL?F=520.20,P=0.00?,DBIL?F=806.86,P=0.00?,IBIL?F=1530.06,P=0.00?,C reactive protein?F=10.70,P=0.00?,interleukin-6?F=83.67,P=0.00?,TNF--??F=48.98,P=0.00?,serum albumin?F=349.33,P=0.00?,leucocyte count?F=26.52,P=0.00?,hematocrit?F=389.83,P=0.00?.5.The Logistic regression equation was statistically significant?X²=59.62,P=0.00?as including serum lipid?TG?TC?HDL?LDL?,blood fat comprehensive index?LCI?AIP?Non-HDL?TC/HDL+TBIL?LDL/HDL+TBIL?,serum bilirubin?TBIL?DBIL?IBIL?and pathological classification of colonic polyps in the equations.The degree of theindexes upon influence the size is as follows:LDL?ExpB=3.61?,AIP?ExpB=3.42?,LDL/HDL+TBIL?ExpB=2.81?,TC/HDL+TBIL?ExpB=2.72?,Non-HDL?ExpB=2.40?,TC?ExpB=1.84?,LCI?ExpB=1.80?,TBIL?ExpB=1.73?.Conclusions1.The pathological types of colonic polyps were statistically different in different gender,age,occupation,diet habit,exercise habit,smoking habit,drinking habit and BMI value for patients with colon polyps.2.The different locations of colonic polyps,growth pattern of colonic polyp and form of colonic polyps has statistics significance in pathological types of colonic polyps.3.The routine indexes of blood lipid?TG?TC?LDL?HDL?,blood fat comprehensive index?LCI,AIP,TC/HDL+TBIL,LDL/HDL+TBIL?,serum bilirubin?TBIL?DBIL?IBIL?and micro inflammatory indexes?IL-6?TNF-??CRP?ALB?WBC?Hct?have significant influence on the pathological types of patients with colon polyps.