| Research BackgroundWith the development of social economy,people's health awareness and the medical security system,esophagogastroduodenoscopy and colonoscopy are gradually accepted by more and more people.It has been reported that gastric polyps can be detected in 1%?4.3%of patients undergoing esophagogastroduodenoscopy in China.In recent years,many studies have shown that the incidence of different types of gastric polyps has changed.The proportion of fundic gland polyps varies in western countries.And the proportion of fundic gland polyps in domestic and foreign countries has increased year by year.Due to the differences in diet,living environment and genetic factors between western countries and China,the epidemiology of gastric polyps in different regions is not the same.Therefore,it is considered that there may be a variety of factors affecting the occurrence of fundic gland polyps.Relevant studies have shown that there may be an internal connection between the occurrence of fundic gland polyps and colorectal tumors.As colorectal adenomatous polyps are recognized as the precancerous lesions of colorectal cancer,it is of great clinical significance to explore the correlation between fundic gland polyps and colorectal polyps.ObjectiveThe purpose of this study was to investigate the influncing factors of fundic gland polyps and the correlation between fundic gland polyps and colorectal polyps.MethodsRetrospectively research all of 100 patients checked out as fundic gland polyps for the first time in the First Affiliated Hospital of Zhengzhou University from September 1,2017 to August 31,2018 and underwent esophagogastroduodenoscopy and colonoscopy at the same time(the interval between two checks should be less than 6 months)as cases.And 200 patients randomly selected from the patients who were diagnosed as chronic superficial gastritis and matched by age and gender from the same period in the hospital as control group.Age distribution,sex distribution,medical history,and test results were studied,as well as FGPs' location,maximum diameter,and number.The type of colorectal polyps,as well as its location,maximum diameter,and number were also studied.SPSS 22.0 version was used for statistical analysis of the data.Results1?Basic information was as follows.The average age of the case group was 49.98± 11.24,including 34 males and 66 females.The average age of the control group was 49.74±10.96,including 68 males and 132 females.There was no significant difference in gender and age between two groups(P>0.05).2?The medical history and test results of the case group and the control group were analyzed as follows.Firstly,univariate analysis was performed on the data.The rate of long-term PPI medication history in the case group was higher than that in the control group,and there was a statistically significant difference between two groups(P=0.027).The rate of helicobacter pylori infection was higher than the control group,and there was a statistically significant difference between two groups(P<0.001).The rates of smoking history,drinking history were lower than the control group,but the difference between two groups was not statistically significant(P>0.05).The triglyceride level of the case group was higher than that of the control group,and there was a statistically significant difference between two groups(Z=-1.980,P=0.048).The levels of fasting blood glucose,total cholesterol,high-density lipoprotein,low-density lipoprotein,CEA,CA199 and CA724 in the two groups were compared,and the differences between the two groups were not statistically significant(P>0.05).Secondly,multiple logistic regression analysis was performed on the long-term use of PPIs,helicobacter pylori infection and triglycerides.The results suggested the long-term use of PPIs was the independent risk factor of fundic gland polyps(P=0.041),and helicobacter pylori infection was the protective factor of fundic gland polyps(P<0.001).Triglyceride was not associated with fundic gland polyps(P>0.05).3?Results of esophagogastroduodenoscopy were as follows.FGPs distribution in case group included 59 cases in gastric body,24 cases in gastric fundus,15 cases in both gastric fundus and gastric body,1 case in gastric Angle and 1 case in gastric antrum.The maximum diameter of FGPs was 1?10mm.The average maximum diameter was 3.48±1.95 mm.The number of cases with a maximum diameter of 1?5mm was 97,and the number of cases with a maximum diameter of 6?10mm was 3.There were 70 cases of single polyp,20 cases of 2?5 polyps,and 10 cases of ? 6 polyps.4?Results of colonoscopy were as follows.In the case group,67 cases of 100 patients who underwent colonoscopy detected no lesions,16 cases of non-adenomatous polyps(3 cases of hyperplastic polyps,13 cases of inflammatory polyps),16 cases of adenomatous polyps(11 cases of tubular adenomas,5 cases of tubulovillous adenomas),and 1 case of adenocarcinoma were detected.In the control group,167 cases of 200 patients who underwent colonoscopy detected no lesions,15 cases of non-adenomatous polyps(5 cases of hyperplastic polyps,10 cases of inflammatory polyps),16 cases of adenomatous polyps(13 cases of tubular adenomas,3 cases of tubulovillous adenomas),and 2 cases of adenocarcinoma were detected.The maximum diameter of colorectal polyps was 2?10mm in the case group and 1?10mm in the control group,but the difference between two groups was not statistically significant(P=0.274).The detection rate of colorectal polyps was 32.0%(32/100)in the case group and 15.5%(31/200)in the control group and the detection rate in the case group was higher than that in the control group,and there was a statistically significant difference between two groups(P=0.001).There was no significant difference in the detection rate of colorectal cancer between two groups(P=1).5?Comparison of classification groups was conducted.Comparison of the number of colorectal polyps between the two groups was as follows.The case group with solitary polyp had a higher risk of disease than the control group,and there was a statistically significant difference between two groups(P=0.001),while there was no statistically significant difference between two groups with multiple polyps(P>0.05).Comparison of colorectal polyp distribution between two groups was as follows.The case group distributed in the distal colon was higher than the control group,and there was a statistically significant difference(P=0.002).The difference between two groups distributed in the proximal colon and the whole colon was not statistically significant(P>0.05).The detection rate of non-adenomatous polyps in the case group was higher than that in the control group,and there was a statistically significant difference(P=0.023).There was no significant difference in the detection rate of hyperplastic polyp between two groups(P>0.05).The detection rate of inflammatory polyp in the case group was higher than that in the control group,and there was a statistically significant difference(P=0.006).The incidence of adenomatous polyp in two groups was compared,and the case group was higher than the control group,with statistically significant difference(P=0.034).The incidence of tubular adenoma and tubulovillous adenoma in two groups was compared,with no statistically significant difference(P>0.05).6?Patients with colorectal polyps were stratified by sex and age for analysis.The probability of colorectal polyps in the female patients was higher in the case group than in the control group,and there was a statistically significant difference between two groups(P<0.001),while there was no statistically significant difference between two groups in the male patients(P>0.05).There was no statistically significant difference in the probability of colorectal polyps between the two groups in the patients who were younger than 50 years old(P>0.05),and the probability of colorectal polyps was higher in the case group than in the control group in the patients who were 50 or more than 50 years old(P<0.001).Conclusions1?After excluding age and sex as confounding factors,the long-term use of PPIs was an independent risk factor for the development of fundic gland polyps,and helicobacter pylori infection was a protective factor for the development of fundic gland polyps.2?Fundic gland polyps were positively correlated with the occurrence of colorectal polyps.Inflammatory polyps,solitary polyp and polyps in the distal colon were more likely to occur.3?Female patients and patients aged 50 or more than 50,with fundic gland polyps,are more likely to develop colorectal polyps. |
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