Analysis Of Risk Factors For Different Growth Patterns Of Laterally Developing And Pedicled Growth Adenomas

Objective : Colorectal adenoma is the most common precancerous lesion of colorectal cancer,which is cancerous through the classic ’ adenoma-adenocarcinoma ’ pathway.At present,many related studies have found related risk factors for the development of adenomatous polyps,including smoking,drinking,eating habits,blood glucose,blood lipids,etc.However,there are few studies on the risk factors related to different growth patterns of adenomatous polyps.This study further explored the risk factors between laterally spreading adenoma and pedicled growth adenoma through retrospective analysis,and provided reference for the screening,early treatment and prognosis of clinical adenomatous polyps.Materials and methods : Patients with colorectal adenoma as the main diagnosis in the Department of Gastroenterology of the Second Affiliated Hospital of Dalian Medical University from January 2019 to December 2021 were collected.The clinical data of patients with colorectal adenoma who met the inclusion criteria and exclusion criteria were collected and recorded.A total of 463 cases were included.They were divided into pedicled adenoma group(n = 293 cases)and laterally spreading adenoma group(n =170 cases)according to growth morphology.Patients with no obvious abnormalities in electronic colonoscopy were randomly selected as the control group(n = 182 cases).The data of age,sex,history of hypertension,history of diabetes,BMI,blood glucose,blood lipid,liver and kidney function,inflammatory markers and other serological data of the three groups were collected,and the gross and pathological data of the two groups of adenoma with different growth patterns were compared.Multivariate Logistics regression was used to analyze the risk factors of adenomas with different growth patterns in the two groups.Results : 1.Differences in general and pathological characteristics between pedicled growth CAP and lateral development CAP :(1)Pedicled growth CAP is more likely to occur in the left colon,and lateral development CAP is more likely to occur in the right colon.(2)CAP patients with pedicle growth are more prone to multiple,and CAP patients with lateral development are more prone to single.(3)The CAP size of lateral development was larger than that of pedicle growth.(4)Laterally developed CAP is mostly tubular adenoma,and pedicled CAP is mostly non-tubular adenoma.2.Differences in metabolic and other related indicators between the pedicled growth CAP group and the lateral growth CAP group : In terms of fasting blood glucose,age,BMI,ALP,and lymphocyte count levels,the lateral growth CAP group was higher than the pedicled growth CAP group.In terms of height and NLR levels,the pedicled growth CAP group was higher than the lateral development CAP group.3.Whether the pedicle growth CAP group or the lateral development CAP group compared with the control group : In age,glycosylated hemoglobin,systolic blood pressure,diastolic blood pressure,serum uric acid,TG,urea,creatinine,r-GT,neutrophil absolute value level,the pedicle growth CAP group and the lateral development CAP group were higher than the control group.At the HDL-C level,the pedicled growth CAP group and the lateral development CAP group were lower than the control group.Compared with the control group,the pedicled growth CAP group and the lateral development CAP group were more likely to occur in male gender,smoking history,drinking history,hypertension,and diabetes.Conclusion : 1.Differences in gross and pathological features between pedicled growth CAP and lateral development CAP :(1)Pedicled growth CAP is more likely to occur in the left colon,and lateral development CAP is more likely to occur in the right colon.(2)CAP patients with pedicle growth are more prone to multiple,and CAP patients with lateral development are more prone to single.(3)The CAP size of lateral development was larger than that of pedicle growth.(4)Laterally developed CAP is mostly tubular adenoma,and pedicled CAP is mostly mixed adenoma.2.Differences in metabolic and other related indicators between the pedicled growth CAP group and the lateral development CAP group : In terms of fasting blood glucose,age,BMI,weight,urea level,and lymphocyte count,the lateral development CAP group was higher than the pedicled growth CAP group.At the level of height,NLR and r-GT,the pedicled growth CAP group was higher than the lateral development CAP group.