浏览全部资源
扫码关注微信
无症状人群结直肠息肉检出情况及危险因素分析
Detection rate and risk factors of colorectal polyps in asymptomatic individuals
- 第三军医大学学报 2017年39卷第22期 页码：2232-2237
- 作者机构：
400014 重庆，重庆市人民医院消化内科
- 作者简介：
[ 任孟军, E-mail: renmengjun6@163.com REN Mengjun, , E-mail: renmengjun6@163.com
- 基金信息：
DOI：10.16016/j.1000-5404.201707133
中图分类号： R181.32;R574.63;R735.35收稿：2017-07-20，
修回：2017-09-20，
纸质出版：2017-11-30
- 稿件说明：
移动端阅览
王艳丽, 雷微, 亢渝俊, 等. 无症状人群结直肠息肉检出情况及危险因素分析[J]. 第三军医大学学报, 2017,39(22):2232-2237.
Yanli WANG, Wei LEI, Yujun KANG, et al. Detection rate and risk factors of colorectal polyps in asymptomatic individuals[J]. Journal of Third Military Medical University, 2017, 39(22): 2232-2237.
王艳丽, 雷微, 亢渝俊, 等. 无症状人群结直肠息肉检出情况及危险因素分析[J]. 第三军医大学学报, 2017,39(22):2232-2237. DOI： 10.16016/j.1000-5404.201707133.
Yanli WANG, Wei LEI, Yujun KANG, et al. Detection rate and risk factors of colorectal polyps in asymptomatic individuals[J]. Journal of Third Military Medical University, 2017, 39(22): 2232-2237. DOI： 10.16016/j.1000-5404.201707133.
摘要
目的
2
探讨不同病理类型结直肠息肉在无症状人群中的检出情况及相关危险因素。
方法
2
收集我院2013-2016年接受结直肠镜检查但无临床症状的体检者702例的临床资料和肠镜结果。根据肠镜结果和息肉病理类型分组，分析不同病理类型息肉的检出情况及危险因素。
结果
2
腺瘤、增生性息肉(hyperplasic polyp
HP)、广基锯齿状腺瘤/息肉、传统锯齿状腺瘤、炎性息肉的检出率分别为14.0%(98/702)、8.8%(62/702)、0.6%(4/702)、0.1%(1/702)、0.9%(6/702)，进展期腺瘤的检出率为2.7%(19/702)。年龄≥50岁(50~
<
60岁:
OR
=1.712
95%
CI
=1.048~2.798
P
=0.032；≥60岁:
OR
=2.151
95%
CI
=1.146~4.036
P
=0.017)、吸烟≥400支/年(
OR
=1.866
95%
CI
=1.120~3.109
P
=0.017)、一级亲属结直肠癌家族史(
OR
=1.853
95%
CI
=1.038~3.310
P
=0.037)是腺瘤的独立危险因素；BMI≥24.0 kg/m
2
(
OR
=3.1
50
95%
CI
=1.069~9.280
P
=0.037)、2型糖尿病(
OR
=4.430
95%
CI
=1.248~15.721
P
=0.021)是进展期腺瘤的独立危险因素；吸烟≥400支/年(
OR
=2.200
95%
CI
=1.203~4.024
P
=0.010)是HP唯一的独立危险因素。
结论
2
腺瘤及HP是无症状人群结直肠息肉的主要病理类型。吸烟、50岁以上、一级亲属结直肠癌家族史是腺瘤的危险因素，若同时合并2型糖尿病或体质量超重则增加进展期腺瘤的风险。吸烟也是HP的危险因素，且对HP的促进作用可能更显著。
Abstract
Objective
2
To investigate the detection rate and risk factors of colorectal polyps of different histological types in asymptomatic individuals.
Methods
2
From January 2013 to December 2016
a total of 702 individuals without clinical symptoms underwent colonoscopy in our hospital. The clinical data and results of colonoscopy were obtained from each subject. The detection rate and risk factors of colorectal polyps of different histological types were analyzed in the subjects with different colonoscopic and histopathological findings.
Results
2
Among the 702 individuals
the detection rates of adenoma
hyperplasic polyp
sessile serrated adenoma/polyp
traditional serrated adenoma and inflammatory polyp were 14.0% (98/702)
8.8% (62/702)
0.6% (4/702)
0.1% (1/702) and 0.9% (6/702)
respectively; the detection rate of advanced adenoma was 2.7% (19/702). An age over 50 years (50-
<
60 years:
OR
=1.712
95%
CI
=1.048-2.798
P
=0.032; over 60 years:
OR
=2.151
95%
CI
=1.146-4.036
P
=0.017)
smoking more than 20 pack-year (
OR
=1.866
95%
CI
=1.120-3.109
P
=0.017)
and first-degree family history of colorectal cancer (
OR
=1.853
95%
CI
=1.038-3.310
P
=0.037) were identified as the independent risk factors of adenoma. A BMI over 24.0 kg/m
2
(
OR
=3.150
95%
CI
=1.069-9.280
P
=0.037) and type 2 diabetes (
OR
=4.430
95%
CI
=1.248~15.721
P
=0.021) were independently correlated with advanced adenoma. Smoking more than 20 pack-year (
OR
=2.200
95%
CI
=1.203-4.024
P
=0.010) was found to be the only independent risk factor of hyperplasic polyp.
Conclusion
2
Adenoma and hyperplasic polyp are the main histological types of colorectal polyps in asymptomatic individuals. Smoking
age over 50 years and first-degree family history of colorectal cancer are all risk factors of adenoma
and concurrent type 2 diabetes or overweight are associated with an increased risk of advanced adenoma. Smoking is an independent risk factor of hyperplasic polyp and adenomas
and may produce a stronger influence than adenoma on the development of hyperplasic polyp.
关键词
Keywords
references
LEVIN B, LIEBERMAN D A, MCFARLAND B, et al . Screening and surveillance for the early detection of colorectal cancer and adenomatous polyps, 2008: a joint guideline from the american cancer society, the US multi-society task force on colorectal cancer, and the american college of radiology[J ] . Gastroenterology, 2008, 134(5): 1570-1595. DOI: 10.1053/j.gastro.2008. 02.002.
SHUSSMAN N, WEXNER S D. Colorectal polyps and polyposis syndromes[J]. Gastroenterology Report, 2014, 2(1): 1-15. DOI: 10.1093/gastro/got041.
LIU H H, WU M C, PENG Y, et al . Prevalence of advanced colonic polyps in asymptomatic Chinese[J ] . World J Gastroenterol, 2005, 11(30): 4731-4734. DOI: 10.3748/wjg.v11.i30.4731.
赵子夜, 李骏强, 单永琪, 等.结直肠癌平均风险人群结肠镜检查的息肉与腺瘤检出率及其年龄分布情况[J].中华消化内镜杂志, 2014, 31(2): 64-68. DOI: 10.3760/cma.j.issn. 1007-5232.2014.02.002.
ZHAO Z Y, LI J Q, SHAN Y Q, et al . Detection rates of colonoscopic polyp and adenoma in average risk population of colorectal cancer and its age distribution: REtrospective analysis of data from single tertiary medical center[J ] .Chin J Dig Endosc, 2014, 31 (2): 64-68. DOI: 10.3760/cma.j.issn. 1007-5232.2014.02.002.
崔莲, 王志津, 马建新, 等. 328例无症状体检者结直肠息肉检出情况分析[J].东南国防医药, 2016, 18(2): 125-127. DOI: 10.3969/j.issn.1672-271X.2016.02.005.
CUI L, WANG Z J, MA J X, et al . Analysis of 328 cases of colorectal polyp inspection results in asymptomatic persons[J ] . Mil Med J South China, 2016, 18 (2): 125-127. DOI: 10.3969/j.issn.1672-271X.2016.02.005.
屠继军, 陈国昌, 刘芊, 等.无症状人群的大肠息肉相关危险因素分析[J].中华消化内镜杂志, 2015, 32(6): 406-408. DOI: 10.3760/cma.j.issn.1007-5232.2015.06.015.
TU J J, CHEN G C, LIU Q, et al . Risk factors of colorectal polyps in asymptomatic population[J ] .Chin J Dig Endos, 2015, 32(6): 406-408. DOI: 10.3760/cma.j.issn.1007-5232. 2015. 06.015.
FU Z, SHRUBSOLE M J, SMALLEY W E, et al . Lifestyle factors and their combined impact on the risk of colorectal polyps[J ] . Am J Epidemiol, 2012, 176(9): 766-776. DOI: 10.1093/aje/kws157.
SOHRABI M, ZAMANI F, AJDARKOSH H, et al . Prevalence of colorectal polyps in a group of subjects at average-risk of colorectal cancer undergoing colonoscopic screening in tehran, iran between 2008 and 2013[J ] . Asian Pac J Cancer Prev, 2014, 15(22): 9773-9779.
PARK H W, BYEON J S, YANG S K, et al . Colorectal neoplasm in asymptomatic average-risk koreans: the KASID prospective multicenter colonoscopy survey[J ] . Gut Liver, 2009, 3(1): 35-40. DOI: 10.5009/gnl.2009.3.1.35.
CHUNG S J, KIM Y S, YANG S Y, et al . Prevalence and risk of colorectal adenoma in asym ptomatic Koreans aged 40-49 years undergoing screening colonoscopy[J ] . J Gastroenterol Hepatol, 2010, 25(3): 519-525. DOI: 10.1111/j.1440-1746. 2009.06147.x.
JOHNSON C M, WEI C, ENSOR J E, et al . Meta-analyses of colorectal cancer risk factors[J ] . Cancer Causes Control, 2013, 24(6): 1207-1222. DOI: 10.1007/s10552-013-0201-5.
SUCHANEK S, GREGA T, NGO O, et al . How significant is the association between metabolic syndrome and prevalence of colorectal neoplasia[J ] . World J Gastroenterol, 2016, 22(36): 8103-8111. DOI: 10.3748/wjg.v22.i36.8103.
CHIONG C, COX M R, ESLICK G D. Gallstones are associated with colonic adenoma: a meta-analysis[J]. World J Surg, 2012, 36(9): 2202-2209. DOI: 10.1007/s00268-012-1646-5.
LEGGETT B, WHITEHALL V. Role of the serrated pathway in colorectal cancer pathogenesis[J]. Gastroenterology, 2010, 138(6): 2088-2100. DOI: 10.1053/j.gastro.2009.12.066.
YAMANE L, SCAPULATEMPO-NETO C, REIS R M, et al . Serratedpathway in colorectal carcinogenesis[J ] . World J Gastroenterol, 2014, 20(10): 2634-2640. DOI: 10.3748/wjg.v20.i10.2634.
REX D K, AHNEN D J, BARON J A, et al . Serrated lesions of the colorectum: review and recommendations from an expert panel[J ] . Am J Gastroenterol, 2012, 107(9): 1315-1329. DOI: 10.1038/ajg.2012.161.
BURNETT-HARTMAN A N, PASSARELLI M N, ADAMS S V, et al . Differences in epidemiologic risk factors for colorectal adenomas and serrated polyps by lesion severity and anatomical site[J ] . Am J Epidemiol, 2013, 177(7): 625-637. DOI: 10.1093/aje/kws282.
HAQUE T R, BRADSHAW P T, CROCKETT S D. Risk factors for serrated polyps of the colorectum[J]. Dig Dis Sci, 2014, 59(12): 2874-2889. DOI: 10.1007/s10620-014-3277-1.
0
浏览量
0
下载量
0
CSCD
- Meta-XML下载
- BibTeX下载
- Endnote下载
- RefMan 下载
- NoteExpress下载
- NoteFirst下载
关联资源
相关文章
相关作者
相关机构
- 技术支持由北京北大方正电子有限公司提供 京ICP备09064830号-19
京公网安备11010802024621 - 本系统建议在Chrome、 IE9+ 以上版本浏览器阅读本站内容，360浏览器请切换至极速模式
- Cookies帮助我们提供服务并提供个性化体验。使用本网站，即表示您同意我们使用Cookies
