The Clinicopathological Features Of Colorectal Cancer And Adenoma Under Endoscopy Were Reviewed And Analyzed In Our Hospital In Recent 10 Years

Objective: To analyze the change trend of clinicopathological features and detection rate of adenoma,advanced adenoma and colorectal cancer under colonoscopy.Methods: The medical records of patients who completed colonoscopy in the first affiliated Hospital of Shihezi University from January 1,2010 to December 31,2019 were reviewed.To describe the clinicopathological features and detection rate of colorectal adenoma and colorectal cancer(CRC).According to the time of colonoscopy,the patients were divided into two groups: the first five years(2010-2014)and the last five years(2015-2019).The clinicopathological features of colorectal adenoma and CRC,the detection rate of adenoma(ADR),the detection rate of advanced adenoma(AADR)and the detection rate of CRC were compared between the two groups.Results:1.A total of 35714 patients were included in the study.There were 17572 males(49.20%)and18142 females(50.80%).The ratio of male to female was 0.96: 1,and the age ranged from 18 to 96 years(53.88 13.25).In the past ten years,ADR was 17.65%,AADR was 4.45%,and CRC detection rate was 3.71%.2.Male ADR,AADR and CRC detection rate were significantly higher than that of women,(20.97%vs14.43%),(5.54% vs3.40%),(4.45% vs2.99%)(Pall <0.01).3.Both ADR and AADR increased linearly with age.The detection rate of CRC increased linearly with the increase of age,which began in the age group of ≥ 40 years old in males and ≥ 60 years old in females.the chi-square test of linear by linear association was performed(Pall<0.01).4.In the last five years,ADR and AADR increased significantly(13.10% vs 20.33%),and the detection rate of),CRC decreased significantly(4.04% vs 4.69%)(P < 0.01).5.The distal colon was the most common site of colorectal adenoma(48.62%),advanced adenoma(44.30%)and CRC(76.89%)..In the last five years,the proportions of distal colorectal adenoma and advanced adenoma decreased,which were 51.81% vs 48.78% and 50.37% vs 41.22%,respectively(P <0.01).The ADR of the proximal colon increased faster than that of the distal colon(0.775 times vs.0.463times),and the CRC detection rate of the proximal colon decreased more slowly than that of the distal colon(0.234 times vs.0.273 times).6.Tubular adenoma(87.73%)was the most common pathological type of colorectal adenoma.the constituent ratio of tubular adenoma increased in the last five years,the pathological types of other adenomas decreased,the constituent ratio of adenoma < 5mm increased in the last five years,and the constituent ratio of adenoma ≥ 10 mm decreased in all groups(P < 0.01).7.The most common pathological type of CRC was common adenocarcinoma(85.97%),and the most common level of differentiation was moderate differentiation(82.58%).the pathological type constituent ratio of CRC did not change significantly,but the middle differentiated constituent ratio increased,and the highly differentiated and poorly differentiated constituent ratios decreased(P <0.01).Conclusions:1.The detection and removal of adenoma by colonoscopy played an important role in reducing the incidence of CRC.2.The site of adenoma and CRC tends to shift to the proximal end,so attention should be paid to the screening of the proximal colon,and total colonoscopy may be the preferred screening tool.