Risk Factors Analysis Of Different Pathological Types Of Colorectal Polyps

Objective: In this study,the clinical data of colorectal polyps in Fujian were analyzed retrospectively to explore the risk factors of different pathological types of polyps,in order to provide some guidance for the prevention of colorectal cancer.Methods: A total of 579 patients with colorectal polyps diagnosed by electronic colonoscopy during hospitalization in the First Affiliated Hospital of Fujian Medical University from January 2014 to December 2018 were included in this study.Among them,there were 379 cases of adenomatous polyps(CAP group),200 cases of non-adenomatous polyps(NCAP group)(including 123 cases of proliferative polyps and 77 cases of inflammatory polyps),and 255 cases without obvious abnormalities during the same period of enteroscopy as the control group.Collect the data of patients’ gender,age,smoking,alcohol consumption,blood pressure,BMI,fecal occult blood test results,and metabolic indicators such as blood glucose,lipid,liver and kidney function,uric acid in serum.The above indexes were compared between patients with different pathological types of colorectal polyps and the control group.Multivariate logistic regression was used to analyze the risk factors of different pathological types of colorectal polyps.Results:(1)The proportion of male and female polyps was 73.23%(424/579)and 26.77%(155/579)respectively,and the proportion of male patients with polyps was significantly higher than that of female patients.Regardless of the overall,male and female subjects,the proportion of polyps in different age groups increased with the increase of age,and the proportion of polyps after 50 years old increased significantly.Clinically,adenomatous polyps are common,and tubular adenomas are dominant in adenomatous polyps.(2)The male-to-female ratio in the CAP group was 2.44:1,in the NCAP group was 3.44:1 and in the control group was 1.01:1.The detection rate of male patients in the CAP group and the NCAP group was higher than that in the control group,the average age of the CAP group and the NCAP group was higher than that in the control group,the difference was statistically significant(P<0.05),while the difference in gender and age between the CAP group and the NCAP group was not statistically significant(P>0.05).Stratified by the age of 50 years,it can be seen that the proportion of CAP group and NCAP group older than 50 years was significantly higher than that of the control group,the difference was statistically significant(P<0.05).There was no significant statistical difference between CAP group and NCAP group(P>0.05).(3)The proportion of alcohol drinkers in CAP group,NCAP group and control group were 21.9%,26.5% and 14.5%,respectively.The proportion of alcohol drinkers in CAP group and NCAP group was higher than that in the control group.The proportion of smokers in the three groups were 32.19%,39.5% and 18.82%,respectively.The proportion of smokers in the CAP group and NCAP group was significantly higher than that in the control group and the difference was statistically significant(P<0.05).There was no significant difference between the CAP group and NCAP group(P>0.05).(4)The prevalence of hypertension,OB positive rate in feces,proportion of overweight,incidence of HUA,high TG,low HDL,high LDL and high VLDL in CAP group and NCAP group were higher than those in control group,and the difference was statistically significant(P<0.05),while there was no significant difference between CAP group and NCAP group(P>0.05).(5)The levels of systolic blood pressure,BMI,UA,TG,LDL-C,VLDL-C,LT/AST,γ-GT,creatinine,LDH and ALP in the CAP group and NCAP group were higher than those in the control group,while the levels of Apro-A1,Apro-A1/B,HLD-C and GFR were lower than those in the control group,and the differences were statistically significant(P<0.01).There was no significant difference between the CAP group and NCAP group in each index(P>0.05).There was no significant difference in TC and Apro-B between the three groups(P> 0.05),with the decline of GFR,the incidence of CA P was significantly higher than that of the control group.(6)The proportion of polyps longer than 1 cm in CAP group was higher than that in NCAP group,and the difference was statistically significant(P<0.05).The proportion of history of hypertension in non-progressive adenomas was higher than that in progressive adenomas,and the difference was statistically significant(P=0.01).(7)Multivariate unconditional logistic regression analysis showed that age,BMI,gender,OB-positive stool,and hyperuricemia were risk factors for CAP occurrence,with OR values of 3.380(95% CI=2.211-5.168),1.963(95%CI=1.283-3.003),1.932(95% CI=1.251-2.985),10.346(95% CI=5.560-19.251),1.777(95% CI=1.118-2.826),respectively.Conclusion:(1)The levels of age,systolic blood pressure,BMI,UA,TG,LDL-C,VLDL-C,ALT/AST,GT,creatinine,LDH and ALP in the colonic polyp group were higher than those in the control group,while the levels of Apro-A1,Apro-A1/B,HLD-C and GFR in the colonic polyp group were lower than those in the control group,which had nothing to do with its pathological type.(2)Male,advanced age,history of smoking and drinking,history of hypertension,family history of colorectal tumor,obesity,positive OB in stool,hyperlipidemia,hyperuricemia and hypo HDL were the risk factors of colonic polyps,but not related to their pathological types.Age,BMI,sex,positive OB in stool and hyperuricemia were independent risk factors for CAP.(3)There was only significant diffierence in the size of poloys among different pathlolgical types of polyps,but there was no significant diffierence in number,positiob and shaps.